About The III

Mission Statement

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

Organization

The III is a program under the fiscal sponsorship of the Illinois Association of Blood Banks, a non-profit organization devoted to education in blood banking and transfusion medicine. 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). We have a memo of understanding with the Asian Association of Transfusion Medicine to produce “wet workshops” on immunohematology in AATM member countries. We also support AATM and other South Asian transfusion medicine educational organizations by participating in their meetings as our resources allow.

The Program

We have identified four ways in which we can promote the understanding and practice of immunohematology in India and other South Asian countries:

Conduct hands-on (“wet”) workshops on immunohematology, including creation of the necessary immunohematology training facilities,
Provide independent learning materials including cases studies, slide presentations, and instructional videos through this website
Provide and support immunohematology instruction at South Asian meetings and workshops on transfusion medicine,
Provide support and consultation for investigation of individual patients and for implementation of improved immunohematologic testing at South Asian blood centers and hospitals in meetings, personal interaction, and through this website.

Accomplishments to date:

Wet Workshops
The III has provided equipment and materials to create two immunohematology (IH) training facilities with our partners at Lions Blood Bank in New Delhi and Rotary Bangalore-ttk Blood Bank. These facilities each have a capacity for 15 participants at a time. They have been used for multiple workshops conducted by III faculty and by faculty and staff of the two respective blood bank

To date III faculty have conducted 120 wet workshops training over 275 blood bank physicians and technical staff at different events including those listed in the table to the right.

By plan we have been handing the teaching of wet workshops at the Delhi and Bangalore facilities over to our capable local colleagues, enabling the core III faculty to develop wet workshops in other South Asian locations.

Venue	Subject	Date	Days	Participants
ISBTI meeting, Ahmedabad, IN	Basic IH techniques	11/’16	3	25
Jeeven BB, Chennai, IN	Comprehensive IH testing	1/’07	6	12
ISBTI meeting, Bhopal, IN	Basic IH techniques	11/’07	2	12
ISBTI meeting, Bhopal, IN	Advanced IH techniques	11/’07	2	12
Staff training, Prathama BB, Ahmedabad	Basic IH techniques	11/’07	2	12
Jeeven BB, Chennai, IN	Comprehensive IH testing	1/’08	6	12
Rotary ttk BB, Bangalore, IN	Comprehensive IH testing	1/’08	5	12
ISBTI meeting, Hyderabad, IN	Basic IH techniques	11/’10	2	12
ISBTI meeting, Hyderabad, IN	IH reagent preparation	11/’10	2	12
Mumbai, IN	Comprehensive IH testing	10/’12	6	12
Lions BB, Delhi IN	Comprehensive IH testing	4/’13	6	15
Rotary ttk BB, Bangalore, IN	Comprehensive IH testing	11/’13	6	15
Lions BB, Delhi IN	Comprehensive IH testing	4/’14	6	15
Rotary ttk BB, Bangalore, IN	Comprehensive IH testing	9/’14	6	15
Lions BB, Delhi IN	Comprehensive IH testing	4/’15	6	15
Rotary ttk BB, Bangalore, IN	Comprehensive IH testing	1/’16	6	15
Lions BB, Delhi IN	Comprehensive IH testing	3/’16	6	15
Rotary ttk BB, Bangalore, IN	Comprehensive IH testing	9/’16	6	15
IGMS hospital, Male, Maldives	Comprehensive IH testing	1/’18	6	12
Lions BB, Delhi IN (Post AATM meeting)	Eval. of a positive DAT	12/’18	3	15

Instruction at Meetings
In addition to the lectures given as part of the workshops, III faculty have delivered multiple lectures and organized or participated in preconference immunohematology seminars at meetings organized by local, national, and international organizations including:

MEETING	Preconf. IH Seminar	LOCATION	DATE	Days
“International Symposium in Transfusion Medicine”		Karachi, Pakistan	2/’04	3
ISBTI annual meeting		Udaipur, India	11/’05	2
SAATM annual meeting		Kathmandu, Nepal	12/’05	2
Freestanding IH Conference		Indore, India	12/’05	1
ISBTI annual meeting	(WW)*	Amedabad, India	11/’06	3
ISBTI annual meeting	(WW)	Bhopal, India	11/’07	2
ISBTI annual meeting		Lucknow, India	12/’08	3
ISBTI annual meeting	(WW)	Hyderabad, India	11/’10	2
SAATM annual meeting	Yes	Dacca, Bangladesh	5/’11	3
SAATM annual meeting	Yes	Columbo, Sri Lanka	12/’12	3
AATM annual meeting, Kathmandu	Yes	Kathmandu, Nepal	9/’14	3
AATM annual meeting		Turkey	4/’16	2
AABB/AATM combined meeting	Yes	Bangalore, India	12/’16	3
AABB/AATM combined meeting	Yes	Delhi, India	12/’18	3

* “Wet workshop”, see previous table

Our Website

The website you are viewing now includes instructional materials focused specifically on immunohematology including slide presentations, videos we have made, and immunohematology procedures. The latter are downloadable in Microsoft WORD so that they can be used to develop the an institution’s own immunohematology procedure manual. Our goal is to continue to develop this website to the point that a motivated individual can teach themselves much of immunohematology independently from this source.

Support and Consultation

Colleagues and former students consult the III faculty in real time regarding individual immunohematological problems on patients and donors through the “Consult Us” email button on this website, as well as through the AATM IH working group administered by our colleague Dr. Ankit Mathur on WhatsApp.

Serologic centrifuge

Although semi-automated and automated immunohematologic testing using gel, solid phase, and other test platforms have become common in well-funded South Asian blood bank laboratories of hospitals and blood centers, manual “tube testing” is probably most common and some laboratories still use slide testing, particularly for initial testing of blood donors. When tube testing is performed laboratories in South Asia often use all-purpose centrifuges which require a 1 minute spin for agglutination testing and a 10 minute spin for cell washing, as opposed to a 10 second and 1 minute spin respectively for a higher rpm centrifuge specifically defined for this purpose. And automated cell washers are rarely available. This makes tube testing slow and cumbersome, and works against its availability for specialized testing in labs using non-tube test methods.

The barrier to acquisition of equipment for efficient tube testing is cost. Serologic centrifuges made in the United States or Germany are expensive for a lab in a resource-limited country, and in that context acquisition of non-tube-test equipment that requires less skill and experience to yield accurate routine results may be more attractive. Nonetheless, in order for a blood bank to have access to a complete range of techniques for dealing with problems such as cold- and warm-reactive antibodies, access to tube-test methods is essential. Therefore III faculty early on identified availability of an inexpensive serologic centrifuge as a priority, and began to look for an Indian manufacturer of blood bank equipment

After discussion with III faculty engineers of the Remi company of Mumbai developed multiple prototypes, one of which III faculty suggested for development. The III sent associate director Sue Johnson to Mumbai in October, 2014 to assist in initial validation of the centrifuge, and it has subsequently been used successfully in multiple III wet workshops. This centrifuge is available at an attractive price as the Remi “Quickfuge”.

III Fellowships

Four Indian blood bankers completed fellowships, each consisting of two weeks’ training in the laboratory at Evanston Hospital and two weeks at Blood Center of Wisconsin, and a fifth had an abbreviated and focused visit at the same institutions. Unfortunately, due to limitations in faculty time and increased regulation of observer participation in the US we are no longer only able to provide fellowships.

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.
Dr. Ankit Mathur worked at Evanston Hospital and the Blood Center of Wisconsin in October 2012, with an emphasis on selection and freezing of antibody panel cells.
Dr. Pritesh Rajani completed a 4 week fellowship in July 2014.

Watch Lepakshi talk about her fellowship and the III

Faculty Involved to Date

Jim Perkins, M.D. , III Director

Assistant Professor, Department of Pathology, University of Chicago, Pritzker School of Medicine
Previously Director, NorthShore University Health System Blood Banks, Evanston, Illinois

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

Director, Clinical Education, Versiti-Blood Center of Wisconsin Milwaukee, WI
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

Ankit Mathur

Consultant, Transfusion Medicine, Rotary ttk Blood Bank, Bengalaru, India

Poonam Srivastava

Consultant, Transfusion Medicine, Lions Blood Bank, New Delhi, India

Marilyn Moulds, MT(ASCP)SBB

Vice President of Educational Services, ImmucorGamma, Retired

Support

International Society for Blood Transfusion (ISBT)

The ISBT has provided for the eight wet workshops performed in 2013, 2014, and 2015, and 2016
Support included airfare and accommodations for Ms. Johnson, Ms. Hamilton, and Ms. Combs, as well as for miscellaneous teaching materials.

Immucor-Gamma Inc:

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

NorthShore University HealthSystem Medical Group:

The Director’s travel funds thru 2018 were provided by the NorthShore University Health System Department of Pathology.
The medical group “Good Samaritan Fund” has donated $1000/year for 2006, 2007, 2008, 2010, and 2015, 2016,and 2018

The Rotary Club of the Northshore-Wilmette:

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

Southern Blood Services:

Donation of multiple antibody-containing plasmas for use as patient specimens

Versiti

Donation of Associate Director’s time, supplies and reagents

Duke University School of Medicine

Donation of faculty members time

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.

Cardinal Health Care:

Donation of equipment and supplies

Illinois Association of Blood Banks (ILABB)

The ILABB, a non-profit (501(c)3) organization, is the ‘fiscal sponsor’ of the III. The ILABB is dedicated to transfusion medicine education historically limited to education within Illinois and surrounding states. However, but in adopting the III it has become an organization of international scope. Without their help we could not exist.

Previously the Center for International Health of Milwaukee Wisconsin served as our fiscal sponsor, and we are grateful for their stewardship.