{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:05:39Z","timestamp":1747188339412,"version":"3.40.5"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T00:00:00Z","timestamp":1602547200000},"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":["Transfusion"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Background<\/jats:title><jats:sec><jats:label\/><jats:p>Prozone is a known phenomenon affecting immunoassays causing falsely low or negative results when excess target is present in the test system. For assays used to evaluate immune\u2010mediated platelet (PLT) transfusion refractoriness, prozone\u2010like phenomenon has been described in solid\u2010phase human leukocyte antigen (HLA) antibody testing and can be mitigated by diluting samples or pretreating samples with ethylenediaminetetraacetic acid (EDTA) or dithiothreitol. Prozone phenomenon has not yet been described in solid\u2010phase red blood cell (RBC) adherence PLT crossmatch assays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Report<\/jats:title><jats:p>A 40\u2010year\u2010old female with myeloid sarcoma and PLT transfusion refractoriness underwent repeated solid\u2010phase PLT crossmatches; however, crossmatch\u2010compatible PLTs units did not yield adequate PLT count responses. Class I HLA antibody testing with neat, diluted, and EDTA\u2010pretreated serum demonstrated significant prozone\u2010like effect and the presence of numerous high strength HLA antibodies. Based on this HLA antibody profile, HLA antigen\u2013negative PLTs gave an adequate PLT count response. It was noted that the HLA types of her crossmatch\u2010compatible PLTs were incompatible with her HLA antibody profile (eg, HLA\u2010A2). With ABO\u2010identical, HLA\u2010A2\u2013positive PLT units, a solid\u2010phase PLT crossmatch was repeated using undiluted and diluted EDTA plasma. Undiluted EDTA plasma demonstrated negative or weakly positive PLT crossmatches while the diluted EDTA plasma demonstrated strongly positive PLT crossmatches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The prozone phenomenon can cause false\u2010negative results in solid\u2010phase RBC adherence PLT crossmatch assays, which can be mitigated with sample dilution. In immune\u2010mediated PLT transfusion\u2013refractory patients with high\u2010strength HLA antibodies, sample dilution should be considered to correctly identify compatible PLT inventory.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.16132","type":"journal-article","created":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T11:23:00Z","timestamp":1602588180000},"page":"3055-3059","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["False\u2010negative solid\u2010phase platelet crossmatch results due to prozone phenomenon"],"prefix":"10.1111","volume":"60","author":[{"given":"Rachel K.","family":"Horton","sequence":"first","affiliation":[{"name":"Division of Transfusion Medicine Mayo Clinic  Rochester Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micah D.","family":"Zuccarelli","sequence":"additional","affiliation":[{"name":"Division of Transfusion Medicine Mayo Clinic  Rochester 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