Are there any circumstances in which you would consider PCI for CAV, especially for focal/tubular lesions, if the patient is a candidate for re-transplantation?

Most consider PCI for CAV a palliative intervention. If a patient is a re-do transplant candidate and have other high-risk features related to CAV (e.g. restrictive physiology, arrhythmias, etc), then an evaluation for re-transplant should be pursued. If they are not a candidate, then PCI is certainly reasonable particularly if ischemia is found upon investigation. Importantly, we have no prospective RCTs to study this intervention in this selective population.

I agree with Dr. @Dr. First Last in that the presence of progressive CAV warrants an evaluation for re-do transplantation.

However, on a case-by-case basis, we would consider PCI for amenable, clinically relevant lesions in parallel with the ongoing transplant evaluation.