Last month total of 13 Bombay blood group requests for 16 units. 2 units were found available off the shelf while 7 donations happened. Other units managed by systematic planning and use of alternatives to blood transfusion therapy.
Last one was a real challenging month for Sankalp volunteers. The number of SDP requests were high but the more demanding situation was emerging from multiple Bombay group units requests from all over India. Bombay group in itself being a rare blood group, these multiple requests kept the volunteers looking for donors, the available units and other methods to help the patient's situation. We had requests pouring in from Kerala, Delhi, Ahmedabad, Mangalore, Raichur and other places of Karnataka. Donors from throughout Karnataka, Tamil Nadu and Maharastra were contacted in order to fulfil the requirement.
A pregnant lady from a remote village of Kozhikode was found to have a low hemoglobin with Bombay negative as her blood group. The doctors told her husband that one unit was necessarily required in case she needed to be operated. There was panic in the patients family. When they contacted the helpline, the volunteer got to know that the need was urgent as the delivery may happen anytime. A Bombay negative donor from Tamil Nadu was contacted and he immediately agreed to donate the next day, the patient family went all the way to Chennai to collect the unit. Though the delivery eventually happened after 3 weeks, the presence of the unit enabled the doctor to wait for a normal delivery with adequate backup plan.
Another request came from Dakshin Kannada where a 45+ year old lady had to undergo a cardiac surgery. She was in the ICU and her blood group was found to be Bombay positive. 2 units of Bombay positive were required right away. All the donors from Mangalore and nearby districts were contacted but none were found to be eligible. Further, blood banks of the region were contacted to help us with any donors they had listed. One of the donors from one such list agreed to donate and the doctor proceeded with the surgery with the available unit. The surgery was a success and the there was no requirement of the other unit.
When the volunteers were looking for donors in and around Mangalore, another request for a Bombay positive from a village in Kumta was received on the helpline. A pregnant lady was expecting to deliver in a week and a Bombay positive unit was required to be kept as backup. As the unit was expected to be required after a week or so, the volunteers worked to fetch the unit for heart surgery first. Luckily the unit donated for the heart surgery was not required for that patient during the surgery and this unit was made available for the lady in Kumta. Though the doctor initially did not agree on the idea to get the unit transported from Managlore to Kumta, he relented after understanding the difficulty in getting donors and getting to know the number of people who were waiting for the Bombay group units on the same day.
Continuing from last month was the request for 4 units of Bombay positive for a patient in Davangere. Finally donors from Bangalore came to rescue. 4 units were organised at a separation of 3 days for the patient. While this request was being managed, there were 4 other requests on the helpline for Bombay positive units.
In Bangalore, a 42 year old person had to undergo a leg surgery and required one unit for the surgery to happen. One of the donors were contacted and while he was on his way to the hospital to donate, there was another call for help on behalf of a lady who had delivered a child at a government hospital. At that moment her hemoglobin was 3gm/dl. The donor was immediately requested to donate for this lady as she was critical. The patient who had to undergo the leg surgery had to postpone his surgery and he was not happy about this. The volunteer explained to him about the urgency of need and the critical condition of the other patient and ensured that another unit was arranged for him within a day. With this he was happy and even expressed that he would donate blood after a year (once he is eligible) and requested us to add him also as our donor database.
Just then there was a request from Ahmedabad for one unit, which trigged a search for donors in Maharashtra/Gujarat together with Think Foundation, Mumbai. Luckily we did not have to look much as we got to know that one unit was already available in one of the blood banks in Mumbai and the patient could utilize it.
There was more in store. A 12 year old kid from Bijapur was suffering from Kidney stones and was brought down to Bangalore as he needed a surgery, required one unit of Bombay positive as a back up. One of the regular donor from Bangalore was contacted for donation, he was out of town and agreed to donated after two days. Luckily the surgery was not critical and the surgery was postponed by 3 days. The donor donated and the doctors went ahead with the surgery, the unit was not needed during the surgery.
Another request from a well known hospital in Bangalore wherein a lady was anemic and required one unit to improve her hemoglobin. As the unit was not utilized for the kid, we asked the patient's relative to collect this unit. But when the patients blood sample was matched with the unit in the blood bank, the cross match failed! the lady's blood group was not Bombay positive and was wrongly detected previously. Even though the patients blood group was available in most of the blood banks, the patient's relative had to search for this unit for two whole days because of wrong detection of the blood group!
Another case of wrong detection of blood group came to light when an anemic lady was transfused O postive blood triggering a massive reaction. It was then that her blood group was found to be Bombay positive. Thankfully, the unit donated for the kid was still available and this was utilized for this lady. Further, erythropoietin helped her boost her hemoglobin level.
In the mean time a 21 year old college student had to be rushed to a doctor because he was feeling giddy and tired. He was told that his heamoglobin was less than 5 and a blood transfusion is needed. He was also told about his blood group being Bombay positive. No donors were found eligible in Raichur and surrounding areas. One of the blood bank officers from Raichur contacted us and explained to us about the situation. At this time, we were already looking for 3 units units to satisfy the other requirements mentioned above. After a brief discussion, the blood bank officer went ahead to convince the treating consultant on trying erythropoietin. The requirement of a unit was eliminated and the boy's condition was improving when last updated.
One other request were managed by just convincing the patient's relatives to get their blood groups checked. One donor was found within the family.
It was truly an eventful month. We would like to take this opportunity to thank all the donors and blood bank officers who helped through this. In this month we had doctors and blood banks actively engage in exploring alternatives. Luckily several times they relented on their demands to met in-house donations. While the regular donors saved the day as usual, looking at the situation several donors who were hesitant to donate also came forward to help. Every last option to optimise usage, explore blood alternatives, transport units, find units on shelf, get donations and maintain a clear picture of what is happening across all of these blood requests was employed to save the day.