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Acute Rejection

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Heart Failure

Part of the book series: Cardiovascular Medicine ((CVM))

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Abstract

Rejection in heart transplant recipients is diagnosed via the endomyocardial biopsy. The management of rejection proceeds in a stepwise fashion based on the severity of rejection detected on biopsy and the patient’s presentation, from asymptomatic to hemodynamic compromise with cardiogenic shock. While cellular rejection is often successfully treated with corticosteroids and cytolytic therapy, resulting in a resolution of heart failure and normalization of the ejection fraction, management of antibody-mediated rejection is often more complicated. Patients may have a persistent reduction in ejection fraction, restrictive physiology with recurrent heart failure, and accelerated progression of transplant coronary artery disease requiring ongoing therapy directed against antibody production and function.

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Authors and Affiliations

  1. Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA

    Michelle M. Kittleson & Jon A. Kobashigawa

Authors
  1. Michelle M. Kittleson
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  2. Jon A. Kobashigawa
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Corresponding author

Correspondence to Jon A. Kobashigawa .

Editor information

Editors and Affiliations

  1. Division of Cardiology, Department of Medicine, University of Cincinnati, Cincinnati, OH, USA

    David S. Feldman

  2. Clinic im Park, Cardiovascular Center Zürich, Hirslanden Zurich, Switzerland

    Paul Mohacsi

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Kittleson, M.M., Kobashigawa, J.A. (2019). Acute Rejection. In: Feldman, D., Mohacsi, P. (eds) Heart Failure. Cardiovascular Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-98184-0_20

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  • DOI: https://doi.org/10.1007/978-3-319-98184-0_20

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-98182-6

  • Online ISBN: 978-3-319-98184-0

  • eBook Packages: MedicineMedicine (R0)

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