Figure 1.

Suggested algorithm for use of rATG induction in heart transplant patients (a) without mechanical circulatory support (MCS) or (b) with MCS. CNI, calcineurin inhibitor; HTx, heart transplantation; rATG, rabbit antithymocyte globulin. (a) ¹High immunological risk (e.g. pre-transplant DSA, >4 HLA mismatches, black); post-puertum females; older age (>60–65 years); younger age (e.g. <35 years); children (e.g. <10 years); postoperative bleeding; history of malignancy. ²24-h urine output, estimated GFR, protein/creatinine ratio; define cause of renal dysfunction. ³Estimated GFR ≥60 ml/min/1.73 m² and protein:creatinine ≤0.3 in 24-h urine output analysis. (b) ¹Driveline orificium; mediastinitis; positive blood culture; temperature >38.5 °C (F). ²24-h urine output, estimated GFR protein/creatinine ratio; define cause of renal dysfunction. ³Estimated GFR ≥60 ml/min/1.73 m² and protein:creatinine ≤0.3 in 24-h urine output analysis.