{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:40:06Z","timestamp":1789609206272,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,5,30]],"date-time":"2014-05-30T00:00:00Z","timestamp":1401408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:p>Background: Allograft dysfunction due to presumed antibody\u2010mediated rejection (pAMR) is one of the most serious complications of heart transplantation. Combination therapies of high\u2010dose steroids, intravenous immune globulin, and\/or therapeutic plasma exchange (TPE) are often used in this setting. Methods: We performed a 9\u2010year retrospective review of all episodes of pAMR treated with TPE at our institution. pAMR diagnosis was based on clinical and pathologic findings. Left ventricular ejection fraction (LVEF) was measured at baseline, prior to initiation of TPE, and during the course of treatment. Results: There were 42 patients with 47 episodes of pAMR treated with TPE. The majority of episodes were treated with three TPE; however, eight required only two TPE and five episodes required &gt;3 TPE. All episodes of pAMR had LVEF measured before and after the series of TPEs. The mean pre\u2010TPE LVEF was 38% compared with a post\u2010therapy mean LVEF of 50% (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). In 16 episodes of pAMR, for which LVEF was measured following each apheresis, there was significant improvement of allograft function after the first TPE (pre\u2010TPE mean LVEF of 31% and post\u2010first TPE mean LVEF of 37%; <jats:italic>P<\/jats:italic>\u2009=\u20090.02). Incremental and significant improvement in allograft function continued following each TPE. Changes in human leukocyte antigen\u2010donor specific antibodies and fibrinogen did not correlate with ejection fraction response. Conclusions: The rapid improvement in allograft function in our patients is most likely due to TPE as other pharmacologic interventions have longer onset. TPE should be considered a first\u2010line intervention in the setting of pAMR. J. Clin. Apheresis 29:316\u2013321 2014. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/jca.21338","type":"journal-article","created":{"date-parts":[[2014,5,30]],"date-time":"2014-05-30T05:04:42Z","timestamp":1401426282000},"page":"316-321","source":"Crossref","is-referenced-by-count":12,"title":["Therapeutic plasma exchange rapidly improves cardiac allograft function in patients with presumed antibody\u2010mediated rejection"],"prefix":"10.1002","volume":"29","author":[{"given":"Nirupama","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Pathology University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Vanlandingham","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Alabama at Birmingham Birmingham 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