{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:56:23Z","timestamp":1792043783666,"version":"4.4.0"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,2,25]],"date-time":"2018-02-25T00:00:00Z","timestamp":1519516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The Kidd\u2010null phenotype, Jk(a\u2212b\u2212), occurs in individuals who do not express the <jats:italic>JK<\/jats:italic> glycoprotein. Jk(a\u2212b\u2212) individuals can make an antibody against the Jk3 antigen, a high\u2010incidence antigen present in more than 99.9% of most populations. This presents many challenges to the blood bank including identification of the antibody, masking of other antibodies, and how to provide transfusion support given the rarity of Jk3\u2010negative blood products. Kidd antibodies may cause acute and delayed hemolytic reactions as well as hemolytic disease of the fetus and newborn (HDFN). In this article, we present a series of four practical cases of pregnant women with the anti\u2010Jk3 alloantibody that demonstrate a range of clinical presentations of Kidd\u2010related HDFN.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>We retrospectively reviewed the clinical and blood bank records for four patients and their newborns encountered at institutions in Tennessee, Missouri, Hawaii, and Guam with an anti\u2010Jk3 identified during pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Two cases showed no significant evidence for HDFN, while two cases were of mild\u2010to\u2010moderate severity requiring early delivery due to elevated middle cerebral artery (MCA) flow velocities but requiring only phototherapy for hyperbilirubinemia. No intrauterine or neonatal transfusions were necessary. Anti\u2010Jk3 alloantibody titers ranged from 2 to 128.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Clinical manifestations of anti\u2010Jk3 HDFN are generally mild to moderate. Anti\u2010Jk3 titers were not found to correlate directly with HDFN severity. We suggest a titer of 16 to 32 as a cutoff for implementing enhanced monitoring of fetal MCA flow velocities, as such titers may be indicative of elevated HDFN risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.14548","type":"journal-article","created":{"date-parts":[[2018,2,26]],"date-time":"2018-02-26T06:02:14Z","timestamp":1519624934000},"page":"1157-1162","source":"Crossref","is-referenced-by-count":8,"title":["Jk3 alloantibodies during pregnancy\u2014blood bank management and hemolytic disease of the fetus and newborn risk"],"prefix":"10.1111","volume":"58","author":[{"given":"Shaun","family":"Lawicki","sequence":"first","affiliation":[{"name":"Department of Pathology University of Hawaii Honolulu Hawaii"},{"name":"Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily A.","family":"Coberly","sequence":"additional","affiliation":[{"name":"Department of Pathology and Anatomical Sciences University of Missouri Health System Columbia Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center Nashville Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin","family":"Eichbaum","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology Vanderbilt University Medical Center Nashville 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