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International Society for Heart and Lung Transplantation Scientific Statement on pulmonary antibody-mediated rejection and proposed graft, antibody, and pathology (GAP) definition

Evidence level: scientific statement (modified Delphi); abstract-only

An ISHLT scientific statement proposes a multidimensional GAP definition of pulmonary antibody-mediated rejection and notes a 2-year survival of only 20 percent.

As of . Primary source: Publisher record via DOI.

Summary

An ISHLT workgroup of nine subgroups used a modified Delphi method to update the 2016 definition of antibody-mediated rejection (AMR). The resulting Graft, Antibody and Pathology (GAP) definition reports graft dysfunction, antibody presence and characteristics, and pathological findings. The statement says outcomes remain dismal with a 2-year survival of only 20 percent, and identifies better treatments as a critical unmet need, proposing that a more precise definition could provide a platform for testing new therapies.

Details

doi
10.1016/j.healun.2026.04.019
pmid
42274447
authors
Calabrese F, Levine DJ, Adam BA, Agbor-Enoh S, Benden C, Budev MM, Cochrane AB, Cozzi E, Darley DR, Fishbein GA, Gelman AE, Glanville AR, Greenland JR, Hickey MJ, Ius F, Jaksch P, Jackson AM, Joerns JO, Lor H, Lowery EM, Mangiola M, Morlacchi LC, Murray MA, Nair A, Ocagli H, Parmar JS, Pavlisko EN, Perch M, Rahaghi FF, Roden AC, Roux A, Snyder L, Sweet S, Verleden SE, Visner GA, Vos R, Wikenheiser-Brokamp KA, Zeevi A, Hachem RR
journal
The Journal of Heart and Lung Transplantation
year
2026
volume
45
issue
9
pages
1357-1374

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Information resource only. Not medical advice. Not a substitute for the care of the patient's transplant team.