The first ever meeting of the very special people who have the rarest of rare Bombay Blood Group (BBG) was organised by Sankalp India Foundation on 1st July 2012. Though many more donors were expected to attend the program, eventually we had the participation of 9 BBG donors and 6 family members. The few hours spent together led to extremely productive discussions which should go a long way in improving the availability of BBG for the Society.
The meeting was attended by people who have been at the backbone of the BBG availability in the state. The following people attended the meeting:
- Mr. Anand and Mrs. Vidya Lakshmi H M,
- Mr. Arvind and Mrs. Leela Sharma,
- Mr. B. S. Shreedhar,
- Mr. Harsha and Mrs. Sridevi Archak,
- Mrs. K Lakshmi Kumari,
- Mr. Ramakrishna Lanka V V
- Mrs. Sangeeta and Mr. Raghavendra,
- Mr. Somkumar,
- Mr. Vimal Kumar J
- Mr. Vinod Kumar J
Dr. Vishwanath V from Indira Gandhi Institute of Child Health was present for the meeting and he cleared a lot of doubts and shared from his vast knowledge of transfusion medicine.
The meeting began with a round of introductions and experience sharing. Then the discussion went onto the lack of awareness about BBG and the experiences where the people who had BBG were detected as O+ve by the labs. Sankalp shared the recent development of testing all the people who donate blood voluntarily for BBG, a practice which the organisation and several blood banks have been following for quite some time now.
Considering the fact that a large number of BBG requests are coming in, it must be the case that a large number of people with this rare phenotype are going undetected. This is assumption is validated by the fact that several people who are regular BBG donors today had donated several types as O+ve donors. The group discussed three strategies on detecting more people with BBG.
- Ensure testing of all family members of known BBG individuals whether they are in a position to donate blood or not.
- Campaign for systematic screening of all O+ve donors in blood banks.
- Find strategies to encourage labs that just do blood grouping to add the H antigen screening in their regular procedures.
A strong need was also felt to raise the awareness about this rare phenotype. It was decided that awareness campaign will be initiated to take the awareness about BBG to the masses by active campaigning and through media support.
Dr Vishwanath led the discussion about rational usage of blood. He also made aware about autologous blood donation, intra-operative blood salvage, use of EPO and the other options which can be used to perform surgeries with fewer blood units. It is important that the people who are involved in making available this rare blood group are aware of the newer technologies which could be put to use. It was decided that a website be maintained with all this information so that it can easily be referenced at the time of need.
The meeting also gave a platform to share the networking and co-operation which has come about between the blood banks in Karnataka. Sankalp shared instances of the blood banks of the state coming together to ensure that each unit of BBG was optimally utilised. Sankalp also shared with the BBG donors the work done by Think Foundation, Mumbai which has enabled us to get several units of BBG from Mumbai for patients in various parts of Karnataka.
Taking the community of BBG donors forward the following was agreed upon:
- a new website will be setup in a month's time which will have the provision to enrol BBG donors.
- attempts will be made to track and route as many blood requests as possible through the group so that the alternatives to transfusion and the units available off the shelf in blood banks are used effectively.
- the group will meet once in 3 months
- people who have BBG but who are not participating regularly will be approached individually and attempts will be made to increase their participation
- a Google group will be setup for all BBG donors.
3 family members of the donors were tested for their blood group and 2 of them were found to be having BBG. We are extremely grateful to Rashtrotthana Blood Bank for making available their well furnished conference room for the meeting.
With rich discussions, lot of contacts exchanges and increased awareness, the meeting came to an end for the day. Everyone present was confident that by working together we can safeguard the best interest of the individuals with this are blood group even as we ensure regular supply of the units to the needy.
Dear Sir,Before I answer your
Dear Sir,
Before I answer your question let me cite the following instances:
- A very prominent Bombay blood group donor - Mr Shreedhar had doated blood several times before he got to now that he had the rare Bombay Blood Group.
- A person who came to donate blood voluntarily at KMC Manipal this April was found to be Bombay Blood Group. The same person had donated blood several times before and his group was reported as O.
The need for screening people for Bombay phenotype is urgent. It has been recognised by the authorities governing blood transfusion medicine and by the book, all blood banks are required to do testing for H Antigen.
However, a year back we realised that in practice none of the blood banks were doing the test at the camp site when they test the donors blood group. Their argument was that they do the testing for Bombay blood group in the blood bank if the unit fails to crossmatch with the patient. The problem with this arrangement were:
- that they still did collect a unit of Bombay blood group from the donor without realising the same and kept it on shelf for days. With prior information the donation could be postponed till there was a need.
- if the blood bank was involved in component seperation, the PRBC prepared from the unit would easily pass off as O even to the patient without any ill affect.
Because of these reasons, we convinced the blood banks to start doing the H Antigen screening for the people who are tested as O by the slide method on the spot. Though there was initial resistance to the idea, all blood banks(who do camps with us) agreed that it was a necessary practice, relatively inexpensive and highly beneficial. Thus in all Sankalp blood donation drives and donations (in general) the screening for Bombay blood group started as a routine procedure and it has been so for a year now.
Technically speaking, almost all blood banks today have the required chemicals to screen all O group donors for H antigen. It is only because people are not asking for H screening that the blood banks are not doing it. As explained above, it is more meaningful to do H antigen screening on the spot - before blood is drawn. Each donor who believes his blood group to be O must insist upon the blood bank to test for H antigen. It is a fairly simple test which is done by adding a fourth drop of blood on the blood group testing slide and adding the chemical drop from a bottle with black cap to it.
Since it is required of all blood banks to do screening for Bombay blood group, I think what remains to be done is to find blood banks who miss the test at the time of donor screening and insist upon them to complete H antigen screening as part of the donor selection process.
What we have observed is that every time we find one such blood banks and we take the matter up with the blood bank officer, more often than not, the blood bank officer revises the testing procedure to include testing for H antigen.
So, next time you takeany collegue to donate blood in an emergency, or when you dnate blood, please check to see if people with O group are being screened for BBG. If they are not, kindly take the additional pain of insiting upon the test (or inform us and we will be happy to join you to get the procedure upgraded for that blood bank).
Hope this helps.
dear rajat and the sankalp team, congrats on having successfully managing the lgistic nightmare of managing the bbg requests from across different cities and states. I have a small doubt, are the blood banks equipped to test Hh antigen in separating the bbg from the rest? if so, why not educate them and check for group rarity,. so that more number of donors who are inadvertently donating as O+ or O_ donors?if specific bbs have the test facilities let me know. thanx in advance. chandrakant