There are several antigens belonging to many blood group systems present on the cell membrane of red blood cells. Antigens of two blood group systems-ABO and Rh (A, B, and D) are tested routinely for all the patients and blood donors since these two blood group systems are most antigenic and can cause hemolytic transfusion reaction if there is a mismatch. The other blood group systems- the so called –‘minor blood group systems’ antigens like Duffy, Kell, Lewis, etc. which are not done routinely, but may evoke antibody production (immunization) in a patient after blood transfusion if the transfused unit has the antigen which lacks in the patient. In pregnancy, the fetal antigens inherited from father may evoke an antibody production in the mother. Epidemiological data on prevalence of these antigens forms the foundation of our understanding of various immune- hematological problems like irregular antibodies, their detection by using reagent cell panel and finally intervention by providing corresponding antigen-negative red cell component and avoiding possible immunological reaction in patients who develop such irregular antibody. One of the best ways of providing antigen negative blood in patients with multiple antibodies is to have a panel of registered volunteers typed for at least 18 clinically important antigens across Rh, Kell, Kidd, Lewis, Duffy, MNS, P1 blood group systems. These extensively phenotyped donors’ data forms the Rare Donor Registry
There is elaborate data on prevalence of these antigens in western population but is limited in India. Likewise, these countries maintain a register where volunteer donors typed for at least eighteen (18) antigens or more are registered and willing to donate at the time of “need” in a patient.
Since there is no centralized government initiative to have such a register on a national basis in most countries in Asia, an attempt has been initiated in India under aegis of AATM to have a rare donor register with volunteer donors across several hospitals/blood transfusion services (BTS) in India.
Dr. Aseem K Tiwari is the chief coordinator of this program which would have several regional coordinators from different geographic regions:
North India: Medanta-The Medicity Hospital, Delhi (NCR), India
South India: Rotary TTK blood Bank, Bangaluru, India
West India: Tata Memorial Center, Mumbai, India
Bombay Blood group: Dr. Swati Kulkarni,IIH Mumbai
Iran: Dr. Dr. Mostafa Moghaddam, IBTO, Iran
The antigenic profile of all donors will be available on the AATM web-site and can be accessed by any AATM member. In case a suitable match has been identified the chief coordinator has to be contacted. He may in turn contact the regional coordinator(s) and arrange the logistics.
The rare donor registry should be used sparingly. Kindly try and identify the antigen-negative units from the available blood inventory, if possible. If that does not work out, kindly follow the steps enumerated below:
- Step 1: Visit on www.aatmweb.org. Click on “Rare Donor Registry”
- Step 2: Search for the corresponding antigen negative donor from the database. Use “find option” for easy search.
- Step 2a: Note the donor alphanumeric code(s)
- Step 3: Mail the donor code(s) in chronological order and patient details [age, gender, blood group and alloantibody(s) identified] along-with number of requested units to Dr. Aseem K Tiwari (Chief Coordinator; CC) at firstname.lastname@example.org & email@example.com (copy).
- Step 4: If the donor belongs to another Blood Transfusion Services (BTS), the respective Coordinator will be contacted and then the availability of rare blood donor shall be confirmed. This process may take a day or two.
- Step 5: CC will notify you about the availability and likely date of availability of blood (Red Cells) bag
- Step 6: BTS will bleed the donor and necessary components that will be issued to your blood bank or hospital after obtaining the requisite document (s), for e.g. Requisition Form.
Note: Processing charges will depend on source Blood Transfusion Services (BTS). Blood bag logistics will be responsibility of requesting BTS.