{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T18:59:49Z","timestamp":1766516389476,"version":"3.41.2"},"reference-count":9,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T00:00:00Z","timestamp":1726617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Therapeutic plasma exchange (TPE) is a cornerstone treatment for antibody\u2010mediated rejection (AMR) post\u2010organ transplantation, aiming to eliminate pathogenic donor\u2010specific HLA antibodies (DSA). However, limitations in HLA antibody interpretation due to the prozone\u2010like effect (PLE) can lead to inaccurate assessment of treatment efficacy. We present a case of a heart transplant recipient with suspected AMR, where an unexpected increase in DSA levels post\u2010TPE prompted investigation into PLE. Solid\u2010phase Luminex assays were employed to detect HLA antibodies. Serum was run neat as well as after treatment with ethylenediaminetetraacetic acid (EDTA). Nephelometry was used to detect complement levels. Laboratory analysis of pre\u2010TPE serum revealed higher DSA levels with EDTA treatment, characteristic of PLE. Complement measurements supported complement\u2010mediated interference in the pre\u2010TPE sample. This case underscores the importance of being aware that PLE can occur in HLA testing and can impact the interpretation of TPE efficacy for AMR.<\/jats:p>","DOI":"10.1002\/jca.22144","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T11:12:20Z","timestamp":1726657940000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mitigating the Prozone\u2010Like Effect in <scp>HLA<\/scp> Antibody Testing: A Case Report of Therapeutic Plasma Exchange for Antibody\u2010Mediated Rejection Post\u2010Heart Transplantation"],"prefix":"10.1002","volume":"39","author":[{"given":"Sarah\u00a0K.","family":"Grewal","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Achram","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirotomo","family":"Nakahara","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John\u00a0D.","family":"Roback","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna\u00a0B.","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard\u00a0M.","family":"Gebel","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert\u00a0A.","family":"Bray","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4909-7168","authenticated-orcid":false,"given":"H.\u00a0Cliff","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200301150-00008"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318199c581"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31822872dd"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humimm.2019.04.019"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.22043"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40981-016-0058-1"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000341676"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14752"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trim.2020.101310"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.22144","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T09:44:02Z","timestamp":1730108642000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.22144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,18]]},"references-count":9,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1002\/jca.22144"],"URL":"https:\/\/doi.org\/10.1002\/jca.22144","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"type":"print","value":"0733-2459"},{"type":"electronic","value":"1098-1101"}],"subject":[],"published":{"date-parts":[[2024,9,18]]},"assertion":[{"value":"2024-07-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e22144"}}