Most people are aware of three blood group “antigens”, A, B, and Rh. In fact there are over 300 blood group antigens. When individuals are exposed to the red blood cells (RBCs) of other people by transfusion or pregnancy their immune system can make “antibodies” against antigens that are foreign to their system. This is the same process that makes us immune to bacteria and viruses. In the case of RBCs such immunity causes us to be “incompatible” with foreign blood group antigens and the RBCs that bear them, and most often to destroy the incompatible RBCs.

In many countries blood banks deal with compatibility problems by detecting antibodies before transfusion, identifying the blood group against which they are directed, and then providing RBCs that lack the offending blood group antigen. This is the science of “immunohematology”. However, blood banks in many developing countries lack the technology to identify blood group antibodies. This includes most of the blood banks in India. Every day blood bankers in India transfuse RBCs that they know are incompatible, and they do this with dread that the patient will experience serious complications.

Patients can also make antibodies against their own RBCs. If these antibodies are potent enough to destroy RBCs the patient can become anemic and may die. This type of anemia is called Autoimmune Hemolytic Anemia (AIHA). Another immunohematologic disease is called Hemolytic Disease of the Fetus and Newborn (HDFN). In HDFN, pregnant women make blood group antibodies that destroy the RBCs of the fetus they are carrying or of the baby soon after it is born. In the 1950’s and 1960’s HDFN was the most common cause of death of fetuses and newborn babies in the United States. It remains a significant cause of infant mortality in India.

In order to identify and properly treat these problems blood banks must have the technology to identify blood group antibodies.

Blood group antibody identification is an important part of providing safe transfusion and becomes an issue when the medical system is sophisticated enough to frequently need and use transfusions. For example, multiple transfusions are often needed to support patients who are being treated with chemotherapy for cancer. Patients who get multiple transfusions frequently make blood group antibodies. And more and more patients in India are receiving sophisticated cancer chemotherapy. The same is true for cardiac surgery, stem cell and organ transplantation, and a host of other advanced procedures.

Given the increase in blood transfusion in India, Indian blood bankers identify learning to perform blood group antibody identification as a priority.

Blood group antigen structure diagram, with permission from United Blood Services

How You Can Help

The III is grateful for financial contributions.  These support travel by our faculty to meetings in India and travel of our students to the United States for extended training.  (Please note that the director’s travel is entirely funded by his employer, NorthShore Medical Group.)  Your contribution leverages the generous support of the other organizations listed on the “About the III” page.   Financial contributions can only be made by check at this time.  Please make checks out to “The Center for International Health” with “Indian Initiative” on the memo line and mail them to:  9501 Watertown Plank Road, P.O. Box 1997, Milwaukee, WI  53226.

In addition to financial contributions we welcome contributions of equipment, particularly serologic centrifuges, dry heat incubators, and cell washers.  If you have such items please contact us at the link below and we will arrange shipping.

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