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Solid organ transplantation has by now become a common medical procedure.Owing to the introduction of new immunosuppressive drugs, the allograft lossdue to acute rejection has been reduced significantly over time. Tragically,the number of donor organs lost due to allograft vasculopathy (AV), generallynamed chronic vascular rejection or chronic rejection, has remained significantand unchanged for decades. We argue that designation of AV as chronicrejection, and its classification as a delayed long-lasting reaction ofrecipient immune effectors against donor alloantigens have given us the wrongimpression that we have identified the necessary cause of the disease. However,whatever treatment options we have in the anti-rejection toolbox, despite theirsuccess in treating acute rejection, do not work for AV. Yet, the scientificcommunity has continued to conceptualize and approach AV within thealloimmunity and rejection model. Due to unproductive research from thealloimmunity perspective, the number of transplanted hearts lost due to thispathology today is almost the same as it was fifty years ago. We believe thatthis phenomenon falls under the rubric of linguistic relativity, and that thelanguage we chose to name the disease has restricted our cognitive ability tosolve the problem. While the initial perception of the AV as chronic rejectionwas logical and scientific, the subsequent experience revealed that suchperception and approach have been fruitless, and likely are incorrect.Considering our tragic failure to prevent and treat allograft vasculopathyusing all available knowledge on alloimmunity and rejection, we must finallydisassociate the former from the latter. A good way to start this process is tochange the words we are using; particularly, the words we chose to name thedisease. We have to step out of the alloimmunity rejection box

The rejection that defies anti-rejection drugs. Chronic vascular  rejection (allograft vasculopathy): The role of terminology and linguistic  relativity