{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T10:43:02Z","timestamp":1780483382074,"version":"3.54.1"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T00:00:00Z","timestamp":1668384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Early detection of cardiac allograft rejection is crucial for post\u2010transplant graft survival. Despite the progress made in immunosuppression strategies, acute cellular rejection remains a serious complication during and after the first post\u2010transplant year, and there is a continued lack of consensus regarding its treatment, especially in pediatric transplant patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An open request was placed via the listserv to the membership of the Pediatric Heart Transplant Society (PHTS). Along with a broad literature search, numerous institutional protocols were pooled, analyzed and consolidated. A clinical approach document was generated highlighting areas of consensus and practice variation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The clinical approach document divides cellular rejection by International Society for Heart and Lung Transplantation grades and provides management strategies for each, including persistent cellular rejection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cellular rejection treatment can be tailored to the clinical status, graft function, and the grade of cellular rejection. A case of mild and asymptomatic rejection may not require treatment, whereas a higher\u2010grade rejection or rejection with graft dysfunction or hemodynamic compromise may require aggressive intravenous therapies, changes to maintenance immunosuppression therapy and augmented surveillance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14393","type":"journal-article","created":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T07:41:51Z","timestamp":1668498111000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Clinical approach to acute cellular rejection from the pediatric heart transplant society"],"prefix":"10.1111","volume":"26","author":[{"given":"Neha","family":"Bansal","sequence":"first","affiliation":[{"name":"Children's Hospital at Montefiore  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4117-2282","authenticated-orcid":false,"given":"Melanie D.","family":"Everitt","sequence":"additional","affiliation":[{"name":"Children's Hospital Colorado  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0144-1433","authenticated-orcid":false,"given":"Deipanjan","family":"Nandi","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9539-6252","authenticated-orcid":false,"given":"Joseph","family":"Spinner","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine\/Texas Children's Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4051-2185","authenticated-orcid":false,"given":"Jennifer","family":"Conway","sequence":"additional","affiliation":[{"name":"Stollery Children's Hospital University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Defne A.","family":"Magnetta","sequence":"additional","affiliation":[{"name":"Ann &amp; Robert H. 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