The National Institute of Immunohaematology (NIIH) in Mumbai, part of the Indian Council of Medical Research (ICMR), has launched India’s first national rare blood donor registry, an initiative aimed at assisting patients with uncommon blood types, particularly those suffering from thalassemia and sickle cell disease. These patients often require frequent blood transfusions, and the lack of suitable donors can complicate their treatment.
Dr. Manisha Madkaikar, Director of the ICMR-Centre for Research Management and Control of Haemoglobinopathies, highlighted that the integration of this rare donor registry with e-Raktakosh, the government’s existing blood availability portal, is under discussion. This linkage is intended to streamline the process of locating matching donors and blood banks for individuals with rare blood types while enhancing the efficiency of blood bank donor records and supplies.
India faces a significant demand for blood, attributed to the high prevalence of blood disorders and complications during pregnancy. Dr. Madkaikar noted that thalassemia alone involves 100,000 to 150,000 patients requiring regular transfusions. The needs extend further, as accidents and medical procedures also contribute to the demand, with over 1,200 road accidents occurring daily, alongside millions of surgeries and cancer-related procedures annually.
Typically, blood banks in India focus on matching only ABO and RhD blood groups. However, the International Society of Blood Transfusion (ISBT) recognizes more than 360 antigens across 47 blood group systems, with many not routinely tested in India. This oversight can result in mismatches due to minor antigens, leading to complications such as red cell alloimmunisation, which is especially prevalent among thalassemia patients. Dr. Madkaikar indicated that 25 percent of immunized patients do not receive adequate transfusion support due to the presence of multiple antibodies or antibodies against high-frequency antigens, highlighting the need for a comprehensive database of rare and extensively typed blood donors.
Rare blood groups are characterized as those lacking high-frequency antigens, are negative for common antigen combinations, or exhibit a null phenotype. The demand for rare blood supplies is challenging and can necessitate extensive searches beyond local blood centres, sometimes spanning nationally or even internationally. A well-maintained registry of rare blood donors is crucial for addressing these needs effectively. Up until now, 27 countries have established national rare donor registries; India had not been one of them until this initiative.
In 2019, the ICMR-NIIH had already begun a project aimed at screening 4,000 regular ‘O’ group blood donors using advanced molecular techniques in collaboration with various hospitals. This effort identified over 600 donors who were negative for a combination of antigens, as well as around 250 very rare blood group donors, including 170 donors from the Bombay blood group—an exceptionally rare type in India with an annual requirement of 120 to 150 units. To manage this inventory, a web-based portal, the ICMR-Rare Donor Registry of India (RDRI), was developed to facilitate the timely provision of blood to patients.
The integration of the rare donor registry with e-Raktakosh aims to allow all blood banks to contribute to this registry, thereby enhancing its scope and reach. As India continues to navigate the complexities of blood donation and transfusion needs, this initiative marks a significant step towards improving the availability of rare blood types and ensuring that patients receive the care they require.
-Raja Aditya
