BENGALURU: In what could be the first case of a ‘pp’ blood group or ‘P null’ phenotype patient being identified in India, a 45-year-old man who was admitted to Kasturba Medical College, Manipal, has been confirmed to have the rare blood group by UK’s International Blood Group Reference Laboratory.
On May 11, he was admitted to the hospital for a femur fracture and required surgery for which one or two units of blood was required for transfusion. After failing to find a compatible blood unit even after cross matching with more than 80 units, his haemoglobin was increased to the desired level using other medications and the team performed a bloodless surgery.
He was discharged on June 2. There are more than 200 minor blood group antigens known besides A, B and Rh. A blood type is considered rare if fewer than 1 in 1,000 people have it. Dr Shamee Shastry, Professor and Head of the Department of Transfusion Medicine, Immunohaematology and Blood Transfusion, told The New Indian Express, “In India, rare blood groups are Bombay phenotype and INRA (India RA) blood group that was recently identified in India. This is the first reported case of pp blood group. We have initiated a rare donor screening programme, with that we hope to find donors for this rare phenotype.”
“Across the world, the prevalence of this blood group is based on ethnicity and genetic nature of the individual. It varies from place to place. There was a study in European population which concluded that 1 in 5.8 million have pp blood group. There are no well-established registries for rare blood groups. It is very difficult to get blood from other countries because of the time involved. If it’s an emergency transfusion, we need to have our own national registry,” she added.
The cost involved in transporting a rare blood group unit is quite high considering the high testing and transportation costs when compared to Indian rates. “It is not cost effective. Since we have quite a lot of blood transfusion centres in India, it’s time we have a rare donor registry. Now this patient’s haemoglobin is fine so he does not require transfusion,” she said.
ABO and Rh D are the commonly typed blood group systems. However, a person is said to have rare blood group when he lacks the high-frequency antigen or multiple common antigens. The patient had PP1Pk antibody in his blood that is known to cause recurrent abortions in women and has a potential to cause acute intravascular haemolytic reaction to incompatible blood transfusion.