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Our experience with Bombay Blood Group


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Sankalp India Foundation(r)'s experience with management of Bombay Blood Group shared at the 2nd Annual Conference of Indian Society of Transfusion Medicine, Bangalore on 15th September 2013. Visit /

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Our experience with Bombay Blood Group

  1. 1. Our Experience With Bombay Blood Group Sankalp India Foundation®
  2. 2. Bombay Blood Group? • Do we all know about it? • Individuals with the rare Bombay phenotype (hh) do not have H antigen the antigen which is present in blood group O • As a result, they cannot make A or B antigen on their red blood cells. • They have anti-H in the plasma and consequently – They can donate RBCs to any member of the ABO blood group system – but they cannot receive any member of the ABO blood group system's blood
  3. 3. Prevalence • No comprehensive study done to show prevelence. • Estimates for the nation say 1 in 17,000 individuals with high prevelence in Andhra Pradesh, Tamil Nadu, Karnataka, Maharashtra and Gujarat – even up to 1 in 4500 in some areas.
  4. 4. Sankalp Emergency Wing • This team of Sankalp India Foundation works to ensure that the people who don’t find blood from the blood banks are helped • Works on the corner cases of blood transfusion medicine and extremely rare blood group requests • Been handling Bombay Blood Group Requests for 5 years now.
  5. 5. How many requests did we manage? • Does not include requests where we did not help. • 1 patient counted as 1 request.28 56 68 118 Total Requests Total Blood Units Requested Bombay blood group requests 2011-12 2012-13
  6. 6. Where are the blood requests coming from?
  7. 7. Our Experience of Relevance to Blood Banks
  8. 8. Situation with Detection • We are not detecting as many BBG as we should • Not everyone is doing enough Bombay Blood Group(BBG) tests. Bombay blood group donors donated several times before being detected and informed. • Testing at time of issue it is futile as it leads to wastage. • If you are doing components then you are likely to miss Bombay blood group. Red cells are compatible and plasma rarely used.
  9. 9. False Detection • Within 2012-13 we have had 5 instances of incorrect detection of blood group followed by wrong transfusions causing severe haemolytic reaction and more complications. • The patient ended up needing more units of blood than what would have been required initially.
  10. 10. Problems with Availability • With 10 units required each month Sankalp pushed the limits to ensure that each willing donor and each donated unit was used optimally. Following issues were observed: – Several small lists of Bombay Blood Group donors were being maintained. Sub-critical mass leading to staggered availability. – There were attempts to reserve the donors for donations for specific institutions – The good donors, who donated regularly were being called by everyone – emotional blackmail was rampant! – Remaining units post procedures were not being utilised.
  11. 11. Managing Bombay Blood Group
  13. 13. Awareness and Education • Sankalp Patrika shares experience with Bombay Blood Group every month - education cum sensitisation. • All Sankalp blood donation drives has pre- screening of donors for Bombay blood group – 1 donor detected • Media and mass publicity
  14. 14. Cold Chain and Logistics Minimum discomfort to donor. Minimum cost to patients. • Temperature controlled logistics for 4, 8 12, and more than 12 hours. • Resolution of regulatory and legal requirements fro transfers . • Liaison with airlines and blood banks nationally. • Consideration for poor patients • Crisis management protocols
  15. 15. Aggressive use of alternatives • Family screening locally • Use of EPO • Autologous donations wherever applicable • Intra-operative blood salvage • Double red cell donations (not yet used) • Move to better centres – conservative procedures and better equipment
  16. 16. Recommendations: Blood Banks • Do BBG test at screening stage for donors • Communicate collection of BBG immediately • If unutilised intimate network • Share donor details • Learn proper packaging and transportation essentials
  17. 17. Recommendations: Donors • Connect and network • Keep hemoglobin high • Screen all family members – whether they can donate or not!
  18. 18. Recommendation: Authorities • Make Bombay Blood Group screening at time of collection mandatory. • Make it mandatory for airlines to transport Bombay Blood Group Units – Possibly free of charge. • Come up with a clear policy for national and international transfer of blood and leave regulation in the hands of just 1 department. • Provide facility for cryopreservation – But . .
  19. 19. Questions
  20. 20. Thank you 