Better Management and Storage for Bombay Blood Group units Required

In the recent days, Sankalp receiving requests for a Bombay blood group unit has become a norm. In the last month, Sankalp received a request from one of the hospitals from Bangalore. The patient had suffered a minor heart attack and her hemoglobin was initially 5.7. In order to proceed further with the treatment, doctors had instructed the patient's son to get 2 units of Bombay Oh positive.

The patient's son immediately contacted the Sankalp helpline and the request was forwarded to Sankalp’s emergency team which swung into action. The team spoke to the family to try and understand the situation. The patient's son himself being a doctor knew the blood unit was rare to find and expressed that if at least one unit was transfused to the patient immediately, the condition of the patient would be stable.

The volunteer was aware that one unit of Bombay Oh Positive blood group was available in one of the standardized blood banks within Bangalore. This info was passed on to the patient side. Since the hospital was at a reasonable distance from the blood bank the patient side was also given instructions on how to package and fetch the unit. 
The patient side immediately fetched the unit form the blood bank hoping that the unit will be transfused to the patient same day.

But this was not the case, when the hospital started the procedure to cross match the unit with the patient's blood sample it was found that the unit was heamolized and declared that it was unfit for transfusion. This was informed to the patient side immediately and the patient's son informed this to our volunteer and requested the volunteer to help him fetch another unit.

The unit could have been heamolized either because,

  1. The unit's cell life was expired or close to expiry date.
  2. The unit was not stored properly in the blood bank storage due to which the blood cells would have begun to heamolize.
  3. The packaging of the unit was done improperly and hence during transportation, the blood cells got heamolized.
  4. The receiving hospital did not take the necessary steps to store the unit before testing it.

On speaking to the patient side, the volunteer found out that the unit was well packaged with ice packs within a box. It’s a very rare situation that the unit would get heamolized with such packaging. This was not the first time a blood unit was getting transported from one blood bank to another. Rare units were even transferred across states during an event of unavailability.

Though donors were approached and the patient’s requirement was fulfilled soon, such a rare unit should have been handled with more care, stored in a better way and should have been utilized for a requirement. We have come across cases wherein patients with hemoglobin less 3 wait for more than a week just to find one single unit of Bombay blood group. In some cases, the blood banks would not even detect a Bombay blood group unit, until the unit fails to cross match with majority of O positive unit and by this time the unit would be close to its expiry.
In another incident, the unit was transferred from Mumbai to Bangalore for a patient’s operation and was later not utilized. This unit lay in the shelves of the blood bank unutilized, and eventually got expired. It was the same time when Sankalp emergency team was handling two parallel requirements of Bombay positive and our volunteers continued to look for donors across the state, unaware of the fact that a unit was already present in a blood bank. This unit may have been better utilized than rot in the refrigerator of a blood bank!

The collection and storage of Bombay blood group unit should be managed in a better way. 

Important points for Blood banks 

  1. Collect and preserve a Bombay Oh Positive / negative unit in SAGM solution. This increase the life of Red cells up to 42 days.
  2. If a Bombay blood group is been detected in your blood bank and there is no immediate requirement of the unit you know of, or the unit was donated for a patient and is no longer required to be transfused, please inform about the unit to Sankalp helpline on 9480044444. Our volunteers will try and make sure the unit is used in the best possible manner.
  3. If there is a requirement of a Bombay Oh Positive/Negative unit, please contact Sankalp helpline. Any available unit if know to us can be utilized before we try and contact any donor to donate.
  4. If there is any donor’s blood group is detected as Bombay Positive/Negative. Please inform Sankalp about the donor details so that the donor can be explained to about how rare his/her blood group is and motivate him to turn into a regular emergency donor.
  5. If there is a requirement to transport the unit to a far of distance, package the unit well. The blood bag should be wrapped well in plastic packet, cover the packet with ice pack and then place the packet along with the ice pack within a thermocol box. This should keep the unit safe for up to 8 hours.  

This way we can ensure that there are no units lying on the shelves unnoticed or wasted unnecessarily and no patient relative panics or undergoes a trauma before he arranges for a Bombay Blood unit