Antibody-mediated rejection of the lung: A consensus report of the International Society for Heart and Lung Transplantation

Deborah J. Levine, Allan R. Glanville, Christina Aboyoun, John Belperio, Christian Benden, Gerald J. Berry, Ramsey Hachem, Don Hayes, Desley Neil, Nancy L. Reinsmoen, Laurie D. Snyder, Stuart Sweet, Dolly Tyan, Geert Verleden, Glen Westall, Roger D. Yusen, Martin Zamora, Adriana Zeevi

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278 Citations (Scopus)


Antibody-mediated rejection (AMR) is a recognized cause of allograft dysfunction in lung transplant recipients. Unlike AMR in other solid-organ transplant recipients, there are no standardized diagnostic criteria or an agreed-upon definition. Hence, a working group was created by the International Society for Heart and Lung Transplantation with the aim of determining criteria for pulmonary AMR and establishing a definition. Diagnostic criteria and a working consensus definition were established. Key diagnostic criteria include the presence of antibodies directed toward donor human leukocyte antigens and characteristic lung histology with or without evidence of complement 4d within the graft. Exclusion of other causes of allograft dysfunction increases confidence in the diagnosis but is not essential. Pulmonary AMR may be clinical (allograft dysfunction which can be asymptomatic) or sub-clinical (normal allograft function). This consensus definition will have clinical, therapeutic and research implications.

Original languageEnglish
Pages (from-to)397-406
Number of pages10
JournalThe Journal of Heart and Lung Transplantation
Issue number4
Publication statusPublished - Apr 2016
Externally publishedYes


  • allograft dysfunction
  • HLA antibodies
  • lung transplantation
  • rejection

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