Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Aug;44(8):e1-e20.
doi: 10.1016/j.healun.2025.02.1690. Epub 2025 Jun 11.

Summary of the International Society for Heart and Lung Transplantation consensus conference on emerging understanding of antibodies and antibody-mediated rejection in heart transplantation

Jon Kobashigawa  1 , Andreas Zuckermann  2 , Adriana Zeevi  3 , Markus J Barten  4 , Patricia P Chang  5 , Monica Colvin  6 , Guillaume Coutance  7 , Anne Dipchand  8 , Stephan Ensminger  9 , Marta Farrero  10 , Marlena Habal  11 , Anne Halpin  12 , Annette M Jackson  13 , Yosef Manla  14 , Kavitha Muthiah  15 , Luciano Potena  16 , Elaine F Reed  17 , Kelly Schlendorf  18 , Palak Shah  19 , Anat Tambur  20 , Simon Urschel  12 , Steven Webber  21 , Lori West  12 , Jong-Chan Youn  22 , Jignesh Patel  14 ; Consensus Conference participants
Affiliations
Review

Summary of the International Society for Heart and Lung Transplantation consensus conference on emerging understanding of antibodies and antibody-mediated rejection in heart transplantation

Jon Kobashigawa et al. J Heart Lung Transplant. 2025 Aug.

Abstract

The understanding of circulating antibodies and their relationship to antibody-mediated rejection (AMR) has yet to be fully elucidated in heart transplantation. Circulating antibodies are important in both pretransplant and post-transplant. In the pretransplant period, the more antibodies detected in a patient awaiting heart transplantation often significantly reduces the chance of obtaining a compatible donor heart. In the post-transplant period, de novo antibody development against the donor heart remains a challenge to manage. In both pre- and post-transplant scenarios, it is not known what approach is optimal for treating these patients with circulating antibodies. To address these unmet needs, a consensus conference was organized on April 18, 2023, endorsed by the International Society for Heart and Lung Transplantation. The conference represented a collaborative multidisciplinary effort by experts in cardiothoracic transplantation from across the world to understand and discuss the optimum approach and treatment of circulating antibodies and AMR in heart transplant candidates and recipients. The conference served as a forum to better understand antibodies and AMR and their impact on transplant patients. The nature of this consensus is to prepare a platform and pave the way for further detailed studies. The findings and consensus statements are hereby presented.

Keywords: antibodies; antibody-mediated rejection; biomarkers; clinical outcomes; heart transplantation.

PubMed Disclaimer

Conflict of interest statement

Disclosure statement Jon Kobashigawa received research grants from CareDx Inc., Sanofi-Genzyme, and CSL-Behringer. Andreas Zuckermann held leadership position at ISHLT (past president, board of directors). Monica Colvin received grant support from Natera and serves on Natera’s scientific advisory board. Anne Dipchand received support for attending meetings and/or travel from Hospital for Sick Children, and holds leadership positions at the American Society of Transplantation and David Foster Foundation. Marta Farrero received personal payment from Chiesi, received support for attending meetings from Novonordisk and Abbott, holds a leadership position at ISHLT, and her institution received equipment support from AstraZeneca. Marlena Habal received grant support from Bristol Myer Squibb. Annette M. Jackson received consulting fees from Hansa Biopharma, received honorarium from One Lambda ThermoFisher - Speaker Bureau, and received HLA typing reagents from CareDx. Kavitha Muthiah received speaker honorarium from Abbott and Novartis. Luciano Potena received consulting fees from Biotest, Roche diagnostics, received honorarium from Takeda, Abbott, Biotest, and holds a leadership position at ESOT. Elaine F. Reed received several grants (R01AI173050, 1U19AI172713-01, P01AI120944, 2R01AI135201-06, 1U01AI179524-01), received consulting fees from Regeneron, received support for attending meetings from the Federation of Clinical Immunology Societies and serves on the board of the federation. Palak Shah received NIH K23 - 1K23HL143179 grant, received consulting fees from Merck, Natera, JVP Labs, Tosoh Biosciences, Ortho Clinical Diagnostics, and has Stock Options in Procyrion. Simon Urschel received a grant from the Canadian National Donation and Transplant Research Program and serves on the program’s data safety monitoring board. Lori West received support from the Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, Canadian Glycomics Network, Heart and Stroke Foundation of Canada, Enduring Hearts Foundation, and Women and Children's Health Research Institute, and serves as a member of AVIVO scientific advisory board. Jignesh Patel received research grants from Alexion Pharmaceuticals, Pfizer, Alnylam Pharmaceuticals, and AstraZeneca. All other authors have no conflicts of interest to disclose. The authors express their appreciation and gratitude to Christine Sumbi and Venise Strand for their assistance in organizing this conference. Funding was provided by the California Heart Center Foundation.

LinkOut - more resources