title: Role of C1q complement fixing antibody assay in therapeutic plasma exchange management of pediatric cardiac antibody mediated rejection.
abstract: Pediatric cardiac transplant patients with antibody-mediated rejection (AMR) often undergo therapeutic plasma exchange (TPE) to remove pathologic donor specific antibodies (DSA). In cases where DSA persist, it is unclear how long TPE should be continued. We report a case of a 17-year-old cardiac transplant patient with AMR where use of a C1q complement fixing antibody assay helped guide TPE cessation. This report adds to the existing literature that highlights the potential clinical significance of C1q antibodies in AMR management.
authors.affiliation: Division of Hematology, Duke University Medical Center, Durham, North Carolina.
authors.forename: Oluwatoyosi A
authors.identifier: http://orcid.org/0000-0001-7266-7101
authors.initials: OA
authors.lastname: Onwuemene
authors.affiliation: Division of Cardiology, Children's National Health System, Washington, District of Columbia.
authors.forename: Deneen M
authors.initials: DM
authors.lastname: Heath
authors.affiliation: Division of Cardiology, Children's National Health System, Washington, District of Columbia.
authors.forename: Carol
authors.initials: C
authors.lastname: Hartman
authors.affiliation: Division of Laboratory Medicine, Children's National Health System, Washington, District of Columbia.
authors.forename: Edward C C
authors.initials: ECC
authors.lastname: Wong
mesh_terms: D000293:Adolescent; D015922:Complement C1q / Q000276:immunology*; D006084:Graft Rejection / Q000276:immunology / Q000628:therapy*; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007159:Immunologic Tests; D007518:Isoantibodies / Q000097:blood*; D008297:Male; D010951:Plasma Exchange
chemical_list: D007518:Isoantibodies; D015922:Complement C1q
keywords: HLA antibodies; acute rejection; donor specific antibodies; heart transplantation; plasmapheresis