Transfusion Transmissible Infections among Blood Donors at the Blood Bank of Medical College of Gwalior: A 5 Year Study.

Introduction: Transfusion Transmitted Infections (TTIs) are a major problem associated with blood transfusion. Accurate estimates of risk of TTIs are essential for monitoring the safety of blood supply and evaluating the efficacy of currently employed screening procedures. Aims: To determine the prevalence of transfusion transmitted infections among blood donors in greater Gwalior region and its surrounding areas i.e. central India and its comparison with other relevant studies. Place and Duration of Study: Study was carried out at Blood Bank, Department of Pathology, Gajra Raja Medical College, Gwalior, India from January 2009 to December 2013 (5 year study). Methodology: Total 67,123 blood units collected from blood donors were tested for transfusion transmitted infections (TTIs) i.e. HIV I & II, HBV, HCV,VDRL and Malaria parasite at Blood Bank as per guidelines of World Health Organization (WHO) for Asia Pacific region and Food and Drug Administration, Government of India. Results: Out of 67,123 blood units studied, voluntary units were 61309(91.3%) and replacement units were 5823 (8.7%). In the present study total TTIs positive units were 2747 (4.09%) (p=0.000005). Amongst them HBV were 2360 (3.51%) (p=0.000005), HIV positive units were 91(0.13%), HCV were 161 (0.24%), VDRL were 114 (0.17%) and Malaria 21 (0.03%). Conclusion: Our study concluded that amongst all the TTIs in the blood donors in Gwalior and its surrounding area, seroprevalence of HBV was significantly higher than other infections. It is also higher than similar studies conducted in other parts of India.

Transfusion of neocytes concentrate/pooled neocytes in ß-thalassemic patients.

PURPOSE OF STUDY: Study was aimed to observe benefits of transfusion of neocytes/pooled neocytes over packed RBCs by super transfusion regimen in ß-thalassemic patients and its comparison with related studies. MATERIALS AND METHODS: Twelve cases were selected and were equally divided into control and study group in which packed RBCs and neocytes were transfused respectively for one year. In study group, average 8 transfusions were required over 14 in control group. RESULTS: A marked extension of transfusion interval was observed in study group patients receiving neocytes transfusion (avg. 45.8 days; range, 32-54) over control group patients i.e. those receiving conventional packed RBCs (avg. 26.1; range 22-30). There is an average 40.8% reduction in the volume of RBCs required in the study group compared to control group and this difference is statistically significant (p = 0.00075). In study group, 20.1% reduction in iron overload and increase of iron by 9.6% in control group was reported. CONCLUSION: We observed that neocytes transfusion is effective in extending the transfusion interval as well as in reducing the blood requirement and iron over load.

Incidence of Rh Antigens, Phenotype & Probable Genotype in the Population of Gwalior and Chambal Region, Central India.

Introduction: Rhesus (Rh) antigen was discovered in 1940 by Karl Landsteiner and Wiener. In later years, because of its immunogenecity along with ABO grouping, RhD antigen testing was made mandatory before issuing a compatible blood. Presently there are five major antigens i.e. D, C, E, c and e in Rh blood group system. Aims: To know the distribution of major Rh antigens, its phenotype and most probable genotype in the population of Gwalior region i.e. Central India. Place and Duration of Study: This study was carried out at Blood Bank, Department of Pathology, Gajra Raja Medical College, Gwalior, India from 1st October 2008 to 30th September 2010. Methodology: The distribution of Rh antigens, its phenotype and most probable genotype was studied in 1000 samples collected from blood donors, blood recipients and other patients. Samples were tested for ABO blood group and five major antigens of Rh system by tube agglutination method /or by gel technology. Results: Out of 1000 samples studied, the incidence of RhD was 91.6% and only 8.4% samples were negative for D antigen (p=.000005). The Incidence of other Rh antigens i.e. C, E, c and e was 84%, 25.6%, 58.3% & 78.5% respectively (p=.000005) Most common phenotype in RhD positive samples were DCCee (41%) and in RhD negative it was dccee (5.6%) (p= .000005). Eleven samples (1.1%) were negative for antithetical antigens E & e. Most probable genotype in order of frequency was DCe/DCe (R1R1)-41%, DCe/Dce (R1R0)-25.5% & dce/dce (rr)-5.6% (p= .000005). Conclusion: Like previous studies, our study also concluded that there is a wide range of racial and geographical variation in the distribution of Rh phenotype and genotype. The Rh blood group system has vital role in population genetic study, in resolving medico legal issues and more importantly in transfusion practice.

Study of 25 cases of exchange transfusion by reconstituted blood in hemolytic disease of newborn.

This study was aimed to review and establish the practice of exchange transfusion (ET) with reconstituted blood in neonates and to observe fall of bilirubin and its comparison with related studies. Twenty-five neonates diagnosed as hemolytic disease of newborn (HDN) were selected for this study, in which exchange transfusion was carried out as one of the treatments for hyperbilirubinemia. Out of the 25 cases, 15 were of Rhesus (Rh) HDN, while ABO and other blood groups constituted 6 and 4 HDN cases respectively. First, the neonates's and mother's blood samples were subjected to relevant investigations. After that, for neonates having Rh HDN, O Rh negative cells suspended in AB plasma were given, O Rh positive cells suspended in AB plasma were given to ABO HDN; and O positive cells, which were indirect Coomb's cross-matched compatible with neonates' and mother's serum / plasma, suspended in AB plasma were given to the neonates having HDN because of other blood group antibodies. The exchange transfusion (ET) was carried out taking all aseptic precautions by Push-Pull technique with double-volume exchange transfusion method. The average post-exchange fall in serum indirect bilirubin was (52.01%) in all 25 cases, which was found to be more significant than the previous studies. Looking into the superiority of the exchange transfusion in HDN by reconstituted blood, the reconstituted blood can be modified and supplied as per the requirement and conditions.