Trasplante cardiaco en paciente portador de Berlin Heart EXCOR®, con rechazo agudo refractario a tratamiento corticoideo: un reto diagnóstico

We present the case of a 55 year-old patient with severe heart failure secondary to myocarditis with severely depressed ejection fraction, referred to our Hospital for Cardiac pretransplant evaluation. Due to the presence of elevated pulmonary vascular resistance despite optimization of vasodilator medical treatment, an EXCOR^® was implanted as a bridge to transplantation. This article aims to highlight the importance of ventricular assist devices to solve long-term contraindication posed severe pulmonary hypertension for heart transplantation. In addition, we will discuss the complications of immune etiology that may arise in the short-medium term and the different diagnostic techniques and treatment options available to address both humoral and cellular rejection to the transplanted organ.