Table 1: Main complications after heart transplantation. Incidence, risk factors, main consequences and therapeutic and prophylactic strategies. Refer to each complication section in the text for detailed information.

	Rejection	Cardiac Allograft Vasculopathy	Graft Dysfunction	Chronic Kidney Disease	Infection	Malignancy
Incidence	-20% at 1 year -37% at 3 years -45% at 5 years	-8% at 1 year -30% at 5 years -50% at 10 years	Early graft failure: -2 to 28% Late graft failure: -4.3% at 1 year -6.7% at 5 years -10% at 10 years	-6% at 1 year -14% at 5 years -19% at 10 years	-65% at 1 year -85% at 5 years -91% at 10 years	-2.6% at 1 year -14% at 5 years -28%at 10 years
Risk factors	-sensitization to HLA molecules prior to transplantation -infections -pregnancy -blood transfusion -ventricular assist device -previous transplant -donor specific antibodies	-Older donor age -ischemic cardiomyopathy -cytomegalovirus infection -HLADR - antibody matching -number of rejection episodes at 1 year	-older recipient age -pulmonary hypertension -mechanical circulatory support -mechanical ventilation prior to transplant -older donor age -sex mismatch -trauma and intracerebral bleeding as cause of death in donor	-preoperative diagnosis of chronic kidney disease -active hepatitis C virus -older recipient age -female sex -diabetes -acute kidney injury	-young and old age -ventilator support -ventricular assist device -donor black race -female sex -induction therapy -chronic graft dysfunction -reoperation -acute rejection in the early post-transplant period -relapsing viral infections -previous bacterial infections	Skin malignancy: -older age -light skin type -high sunlight exposure Post-transplant lymphoproliferative disorder: -Epstein-Barr virus infection -high intensity of immunosuppression -antibody induction therapy using OKT3 Non-skin cancers: -antibody induction agents -donor history of cancer -female sex -pacemaker prior to discharge -older recipient age -ischemia time
Main consequences	-decreased survival -hospital readmissions -graft failure -arrhythmia -pericardial effusion -cardiogenic shock -sudden cardiac death -cardiac allograft vasculopathy - adverse events secondary to augmentation of immunosuppression	-decreased survival -graft failure -sudden cardiac death -myocardial infarction	-decreased survival -sudden cardiac death	-decreased survival -hypertension -hyperkalemia -proteinuria -rejection/adverse events secondary to modification of immunosuppression	-decreased survival -hospital readmissions -sepsis -multi-organ failure - cardiac allograft vasculopathy - rejection due to minimization of immunosuppression (specific consequences based on the microorganism)	-decreased survival -rejection due to significant minimization of immunosuppression -sudden cardiac death secondary to rejection
Therapeutic/Prophylactic strategies	- augmentation of immunotherapy -induction therapy	-statin therapy -adjustment of immunosuppression -percutaneous coronary intervention -coronary artery bypass grafting -retransplantation	Early graft failure: -mechanical support -extracorpeal membrane oxygenation -ventricular assist device -retransplantation Late graft failure: -heart failure therapy -retransplantation	-modification/minimization of immunosuppression -dialysis -kidney transplantation	-treatment of pre-transplant infections -education on how to prevent infection -testing for sufficient immunization -prophylactic antibiotics -routine monitoring for infection -broad spectrum antibiotics and antiviral and antifungal agents to treat infections - decrease in immunosuppression	-increased cancer screening -screening of Epstein-Barr virus load to detect post-transplant lymphoproliferative disorder in high risk patients -decreased immunosuppression in patients with cancer or at high risk for developing cancer -cancer specific treatment