Controversies in defining cardiac antibody-mediated rejection: need for updated criteria.

Recent years have seen a rising awareness of the significance of cardiac antibody-mediated rejection (AMR) as a result of its formal recognition by the International Society for Heart and Lung Transplantation. New insights on the pathology and clinical behavior of cardiac AMR are at odds with current diagnostic guidelines. This perspective examines some of the contentious and unresolved issues in cardiac AMR as the transplant community makes concrete steps towards updating its defining criteria.