{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:53:33Z","timestamp":1790024013181,"version":"4.0.1"},"reference-count":110,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,12,12]],"date-time":"2021-12-12T00:00:00Z","timestamp":1639267200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>The median survival of patients with heart transplants is relatively limited, implying one of the most relevant questions in the field\u2014how to expand the lifespan of a heart allograft? Despite optimal transplantation conditions, we do not anticipate a rise in long-term patient survival in near future. In order to develop novel strategies for patient monitoring and specific therapies, it is critical to understand the underlying pathological mechanisms at cellular and molecular levels. These events are driven by innate immune response and allorecognition driven inflammation, which controls both tissue damage and repair in a spatiotemporal context. In addition to immune cells, also structural cells of the heart participate in this process. Novel single cell methods have opened new avenues for understanding the dynamics driving the events leading to allograft failure. Here, we review current knowledge on the cellular composition of a normal heart, and cellular mechanisms of ischemia-reperfusion injury (IRI), acute rejection and cardiac allograft vasculopathy (CAV) in the transplanted hearts. We highlight gaps in current knowledge and suggest future directions, in order to improve cellular and molecular understanding of failing heart allografts.<\/jats:p>","DOI":"10.3390\/jcdd8120180","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T01:28:11Z","timestamp":1639358891000},"page":"180","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Failing Heart Transplants and Rejection\u2014A Cellular Perspective"],"prefix":"10.3390","volume":"8","author":[{"given":"Maria","family":"Hurskainen","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology, New Children\u2019s Hospital, Helsinki University Hospital and University of Helsinki, 00290 Helsinki, Finland"},{"name":"Pediatric Research Centre, New Children\u2019s Hospital, Helsinki University Hospital and University of Helsinki, 00290 Helsinki, Finland"},{"name":"Transplantation Laboratory, Helsinki University Hospital and University of Helsinki, 00014 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olli","family":"Ainasoja","sequence":"additional","affiliation":[{"name":"Transplantation Laboratory, Helsinki University Hospital and University of Helsinki, 00014 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6920-4093","authenticated-orcid":false,"given":"Karl B.","family":"Lemstr\u00f6m","sequence":"additional","affiliation":[{"name":"Transplantation Laboratory, Helsinki University Hospital and University of Helsinki, 00014 Helsinki, Finland"},{"name":"Department of Cardiothoracic Surgery, Helsinki University Hospital and University of Helsinki, 00290 Helsinki, Finland"},{"name":"Translational Immunology Program Research Programs Unit, University of Helsinki, 00290 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Sabatino, M.E., Williams, M.L., Okwuosa, I.S., Akhabue, E., Kim, J.H., Russo, M.J., and Setoguchi, S. 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