**7. Rejection treatment**

The treatment of rejection depends on the hemodynamic condition and the grading of rejection according to ISHLT grading. **Table 7** summarizes the therapeutic drugs


#### **Table 7.**

*Cellular rejection treatment.*

in the rejection. Drugs for cellular rejection are *methylprednisolone, immunoglobulin (IVIG), rabbit thymoglobulin (ATG),* and maintenance immunosuppressive drugs [2].

The updated guidelines ISHLT recommends that patients with symptomatic acute cellular rejection should be hospitalized and patients with hemodynamic compromise should be treated in the ICU or an intermediate-care unit with the ability to perform continuous hemodynamic monitoring and administer inotropes (Class I, Level of Evidence C) [2].

The treatment for acute mediate rejection includes methylprednisolone, IVIG, ATG, rituximab, and plasmapheresis. In patients with severe rejection and not responsible for medical treatment, mechanical assistance support may be required.
