Datta Suvro Sankha, Sil Suhasini, Mandal Saikat
Department of Transfusion Medicine, Tata Medical Center, Kolkata, India.
Department of Transfusion Medicine, All India Institute of Medical Sciences, New Delhi, India.
Front Genet. 2023 Sep 11;14:1264853. doi: 10.3389/fgene.2023.1264853. eCollection 2023.
Patients who require blood from rare blood group donors present great challenges even to the most advanced healthcare delivery system. It is most challenging to supply blood for a patient with an antibody to an antigen of high prevalence. The blood donor lacking the corresponding antigen would have an occurrence rate of less than one in 1,000. The International Rare Donor Panel was established in 1965, but since then there has been gross underrepresentation of South Asian countries, including India. There are several challenges to starting a rare blood group donor program in India that include technical, logistical, and administrative limitations. But the main limiting factors are poor availability of trained resources, lack of awareness, absence of antibody screening, inadequate number of laboratories with blood group genotyping facilities, and the decentralized nature of blood transfusion services. Despite that, there were several rare blood groups identified by Indian immunohematologists in the recent past. Recently, a transfusion genomic group has been established in collaboration with the clinical transfusion medicine specialists in India under the GUaRDIAN (Genomics for Understanding Rare Disease in India Alliance Network) initiative to address the domain of rare blood group genomics. Similarly, the National Institute of Immunohematology, Mumbai under the directive of the ICMR (Indian Council of Medical Research) has taken a step to start the RDRI (Rare Donor Registry of India). In this context, we explore the current challenges of setting-up a rare blood group registry in India and future goals from a developing nation's perspective.
即使对于最先进的医疗保健系统而言，需要稀有血型献血者供血的患者也带来了巨大挑战。为对高流行率抗原产生抗体的患者供血是最具挑战性的。缺乏相应抗原的献血者发生率不到千分之一。国际稀有献血者小组于1965年成立，但自那时以来，包括印度在内的南亚国家在其中的代表性严重不足。在印度启动稀有血型献血者计划面临诸多挑战，包括技术、后勤和行政方面的限制。但主要限制因素是训练有素的资源匮乏、意识淡薄、缺乏抗体筛查、具备血型基因分型设施的实验室数量不足以及输血服务的分散性质。尽管如此，印度免疫血液学家最近还是鉴定出了几种稀有血型。最近，在GUaRDIAN（印度罕见病基因组学联盟网络）倡议下，与印度临床输血医学专家合作成立了一个输血基因组小组，以应对稀有血型基因组学领域的问题。同样，孟买国家免疫血液学研究所在印度医学研究理事会的指示下，已采取措施启动印度稀有献血者登记处。在此背景下，我们从一个发展中国家的角度探讨在印度建立稀有血型登记处目前面临的挑战以及未来目标。
