{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T12:23:42Z","timestamp":1755692622057,"version":"3.41.2"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:00:00Z","timestamp":1715299200000},"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":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Anti\u2010PP1P<jats:sup>K<\/jats:sup> alloimmunization is rare given ubiquitous P1PK expression. Prevention of recurrent miscarriages and hemolytic disease of the fetus and newborn (HDFN) in pregnant individuals with anti\u2010PP1P<jats:sup>K<\/jats:sup> antibodies has relied upon individual reports. Here, we demonstrate the successful management of maternal anti\u2010PP1P<jats:sup>K<\/jats:sup> alloimmunization in a 23\u2010year\u2010old, G2P0010, with therapeutic plasma exchange (TPE), intravenous immunoglobulin (IVIG), and monitoring of anti\u2010PP1P<jats:sup>k<\/jats:sup> titers. Twice\u2010weekly TPE (1.5 plasma volume [PV], 5% albumin replacement) with weekly titers and IVIG (1\u2009g\/kg) was initiated at 9\u2009weeks of gestation (WG). The threshold titer was \u226516. Weekly middle cerebral artery\u2010peak systolic velocities (MCA\u2010PSV) for fetal anemia monitoring was initiated at 16 WG. PVs were adjusted throughout pregnancy based on treatment schedule, titers, and available albumin. Antigen\u2010negative, ABO\u2010compatible RBCs were obtained through the rare donor program and directed donation. An autologous blood autotransfusion system was reserved for delivery. Titers decreased from 128 to 8 by 10 WG. MCA\u2010PSV remained stable. At 24 WG, TPE decreased to once weekly. After titers increased to 32, twice\u2010weekly TPE resumed at 27 WG. Induction of labor was scheduled at 38 WG. Vaginal delivery of a 2950\u2009g neonate (APGAR score: 9, 9) occurred without complication (Cord blood: 1+ IgG DAT; Anti\u2010PP1P<jats:sup>k<\/jats:sup> eluted). Newborn hemoglobin and bilirubin were unremarkable. Discharge occurred postpartum day 2. Anti\u2010PP1P<jats:sup>k<\/jats:sup> alloimmunization is rare but associated with recurrent miscarriages and HDFN. With multidisciplinary care, a successful pregnancy is possible with IVIG and TPE adjusted to PV and titers. We also propose a patient registry and comprehensive management plan.<\/jats:p>","DOI":"10.1002\/jca.22120","type":"journal-article","created":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T06:54:45Z","timestamp":1715410485000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Successful management of maternal anti\u2010PP1P<sup>k<\/sup> alloimmunization in pregnancy with therapeutic plasma exchange and intravenous immunoglobulin"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6723-4299","authenticated-orcid":false,"given":"Yannis","family":"Hadjiyannis","sequence":"first","affiliation":[{"name":"Department of Pathology University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7246-4486","authenticated-orcid":false,"given":"Jennifer M.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Michigan Medical School  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Chibisov","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"},{"name":"Transfusion Vitalant, Northeast Division  Pittsburgh Pennsylvania USA"},{"name":"Clinical Aphersis Vitalant, Northeast Division  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Kiss","sequence":"additional","affiliation":[{"name":"Transfusion Vitalant, Northeast Division  Pittsburgh Pennsylvania USA"},{"name":"Clinical Aphersis Vitalant, Northeast Division  Pittsburgh Pennsylvania USA"},{"name":"Department of Medicine University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Gabert","sequence":"additional","affiliation":[{"name":"Transfusion Vitalant, Northeast Division  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan","family":"Sevcik","sequence":"additional","affiliation":[{"name":"Clinical Aphersis Vitalant, Northeast Division  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Bakdash","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"},{"name":"Transfusion Vitalant, Northeast Division  Pittsburgh Pennsylvania USA"},{"name":"Clinical Aphersis Vitalant, Northeast Division  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Binstock","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences UPMC Magee\u2010Women's Hospital, University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn","family":"Kilonsky","sequence":"additional","affiliation":[{"name":"Clinical Aphersis Vitalant, Northeast Division  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristiina","family":"Parviainen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences UPMC Magee\u2010Women's Hospital, University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8746-0549","authenticated-orcid":false,"given":"Alesia","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"},{"name":"Transfusion Vitalant, Northeast Division  Pittsburgh Pennsylvania USA"},{"name":"Clinical Aphersis Vitalant, Northeast Division  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.13042"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.16384"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.21307\/immunohematology-2019-120"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2014.04.007"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00731093"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1983.23483276877.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2006.08.003"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1987.27287150197.x"},{"key":"e_1_2_8_10_1","first-page":"250","article-title":"Molecular basis for an individual with rare p phenotype in P1Pk blood group 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