Mission Statement

The Indian Immunohematology Initiative (III) aims to improve the safety of transfusion in India by teaching Indian blood bankers, both physicians and technical workers, to detect and identify blood group antibodies and to treat diseases caused by red blood cell antibodies.

Organization

The III is a program of the Center for International Health (see below), a non-profit organization devoted to training healthcare workers around the world.  Our educational programs and other activities are conducted by volunteer faculty (see below).  The III is directed by Dr. Jim Perkins; the associate director is Ms. Susan Johnson (see Faculty below).

The Program

We have identified five ways in which we can promote the understanding and practice of immunohematology in India:

• Conduct hands-on (“wet”) workshops on immunohematology,
• Provide support and consultation for implementation of improved immunohematologic testing at Indian blood centers and hospitals,
• Provide and support immunohematology instruction at meetings and workshops on transfusion medicine,
• Host Indian immunohematologists for technical training in partner blood banks,
• Conduct research that will advance the immunohematology mission of Indian blood bankers.

Accomplishments to date

Wet Workshops

To date III faculty have conducted 7 wet workshops training over 85 blood bank physicians and technical staff at 5 different meetings including:

• A three-day workshop on basic techniques at the November, 2006 Indian Society for Blood Transfusion and Immunohematology (ISBTI) meeting in Ahmedabad with 25 students,
• Two, five-day, comprehensive workshops at the Jeevan Blood Center in Chennai, conducted in January 2007 and 2008, each with 12 students,
• Two, two-day workshops, one basic and one advanced, at the November, 2007 ISBTI meeting in Bhopal with 12 students in each.
• A two-day advanced workshop for staff of the Prathama Blood Center in Ahmedabad in November 2007.
• A five-day comprehensive immunohematology workshop at the Rotary ttk Blood Bank, Bangalore in September, 2009

Support and Consultation

We have worked with three blood centers, Prathama in Ahmedabad, Jeevan in Chennai, and Rotary ttk in Bangalore to create the sets of donor RBCs known as ‘panels’ that are necessary for identifying blood group antibodies. Each donor RBC sample in such a panel has a known composition of critical RBC antigens or ‘blood group phenotype’. Antibody identification panels are available commercially, but they are expensive. In addition, commercial panels are typically composed of RBCs from donors of European origin, which may lack the antigens needed to identify antibodies found in Indian patients. This effort has been supported by the III faculty at every stage including provision of typing sera donated to the III (see support, below), consultation on procedures and selection of donors, and confirmation of the donors’ phenotypes here in the United States.

We offer consultation on individual patient cases to our past workshop students, and many have taken advantage of this option. We also provide immunohematology case studies with questions on this website.

Workshop students receive a CD of case studies, recorded lectures, and copies of immunohematology procedures such as those on this website.

Finally, we conducted formal consultations at Prathama and Rotary ttk Blood Centers on selection of immunohematologic procedures to be used at their center, and hope to expand this activity in the future.

Instruction at Meetings

In addition to the lectures given as part of the workshops, III faculty have delivered multiple lectures at four consecutive ISBTI meetings, the 2005 South Asian Society of Transfusion Medicine, and an independent immunohematology symposium in Indore in 2005.

III Fellowships

Three Indian blood bankers have completed fellowships, each consisting of two weeks’ training in the laboratory at Evanston Hospital and two weeks at Blood Center of Wisconsin.

• The first fellow, Lepakshi, then a technician at Apollo Hospital, New Delhi, completed her fellowship in July 2008
• Dr. Poonam Srivastava of ESI hospital, New Delhi, finished her’s in August, 2009.
• The fellowship of Mr. Satish Kumar, Chief Technologist of the Blood Bank at Apollo Hospital, Hyderbad, included attendance at the 2009 AABB annual meeting supported in part by an AABB scholarship.

Watch Lepakshi talk about her fellowship and the III

Research

Individuals make antibodies against the blood groups they lack, and our ability to provide RBCs compatible with these patients depends on the frequency of the blood groups in the blood donor population. The frequency of different blood groups varies in different populations, but there is little information regarding these frequencies in India. We are currently planning a study to determine the blood group genotype of a large number of Indian blood donors with samples collected at Jeevan and Rotary ttk Blood Banks, with genotyping performed at Blood Center of Wisconsin, and with support and funding from the blood bank at Evanston Hospital.

Faculty involved to date:

James Perkins, M.D. , III Director

• Director, NorthShore University Health System Blood Banks, Evanston, Illinois
• Medical Director, Northshore School of Medical Technology
• Assistant Professor, Department of Pathology, University of Chicago, Pritsker School of Medicine

Susan Johnson, MSTM, MT(ASCP)SBB, MS, III Associate Director

• Vice President for Education, Blood Center of Wisconsin (BCW), Milwaukee, Wisconsin
• Director, Specialist in Blood Bank Technology Program
• Director, Transfusion Medicine Program, Marquette University

Martha Rae Combs, MT(ASCP)SBB

• Technical Director of Immunohematology, Transfusion Service, Duke Medical Center

Janis Hamilton, MT(ASCP)SBB, MS

• Manager, Immunohematology Reference Laboratory, American Red Cross, Southeastern Michigan Region

Marilynn Moulds, MT(ASCP)SBB

• Vice President of Educational Services, ImmucorGamma, Retired

Graeme Woodfield, MB, ChB (NZ), PhD, FRCPE, FRCPA

• Honorary Academic Transfusion Medicine Specialist, the University of Auckland

Support

The Rotary Club of the Northshore-Wilmette (www.northshorerotary.info):

• $6000; November 2006 fundraiser
• $8,500; September 2008 fundaiser

NorthShore University HealthSystem Medical Group:

• The Director’s travel funds are entirely provided by the NorhShore University Health System Department of Pathology.
• The medical group “Good Samaritan Fund” has donated $1000/year for 2006, 2007, and 2008.

Immucor-Gamma Inc.:

• Donation of equipment and many thousands of dollars worth of critical blood bank reagents

Cardinal Health Care:

• Donation of equipment and supplies

Bio-Rad India

• Donation of equipment and critical blood bank reagents

Faculty time has been donated by each individual’s home institution. Host institutions provide space, support staff, materials, faculty housing and board, and logistic support.

Center for International Health

An internationally recognized 501(c)3 organization, the Center for International Health (CIH) offers training, consultation, technical assistance, material resources and health systems development techniques to strengthen communities, their health care systems, and the capabilities of their health professionals in emerging and developing countries.

The Center for International Health  serves as the lead agency of an area-wide consortium that comprises an academic health center, the University of Wisconsin-Milwaukee, Marquette University, Milwaukee County Government and its Department of Health and Human Services, and the civic and business sectors, including GE Healthcare.