Yavatmal man with rare blood group system donates his own blood for open-heart surgery

A 50-year-old man from Yavatmal, who perhaps is the only person in India to possess a rare blood group system, had to donate his own blood for an open-heart surgery at Lilavati Hospital.

According to his treating doctors, Rajesh Agarwal was diagnosed with a tumor within the heart (myxoma) after he complained of chest pain and underwent an MRI test. During a blood group test that is required to reserve blood for transfusion prior to scheduling his surgery, Agarwal discovered that his blood group system was Gerbich Phenotype.

“Despite being AB positive, which is quite common, his blood did not match any of the nearly 50 donor blood units tested (including O negative blood group). An extensive immuno-hematological analysis revealed that the patient possessed an additional rare blood group antibody,” said Dr Ruhi Mehra, blood transfusion medicine consultant, who monitored Agarwal’s case.

Facing a challenge to arrange blood, Dr Mehra said Agarwal’s blood samples were referred to the International Blood Group Reference Laboratory (IBGRL), Bristol, UK, because blood group reference laboratories in India are still at a nascent stage to resolve such rare cases.

“IBGRL confirmed that the patient’s cells had the rare Gerbich Phenotype (GE: -2, -3, 4) due to which the patient had formed a clinically significant anti-Ge2 allo-antibody. This is rare for the Indian population. This is the first case of Gerbich Phenotype to be identified in India as per our knowledge,” she said.

Dr Pavan Kumar, cardiovascular and thoracic surgeon who operated on Agarwal on October 20, said his mother, three siblings, and two sons underwent tests, but none were found to be compatible, creating a complex situation. “Heart surgery typically requires a blood transfusion.”

After a series of consultations with Agarwal, Dr Kumar said they decided to use his own blood during the surgery to eliminate the risk of complications from mismatched transfusions.

“He agreed to donate his blood three times over a period of three weeks leading up to the surgery,” Dr Mehra said.

She pointed out that collecting his own blood could also pose a risk to his heart since it was a cardiac case. “Hence, his haemoglobin (Hb) was built up prior to starting his collections. Haematinics (substances essential to the proper formation of blood components) were started to maintain his Hb levels (>11 gm/dl), and three units of his own blood were collected over a period of two-three weeks.”

Agarwal was discharged on Friday. “During a routine blood collection for the surgery, I found out that my blood group system was Gerbich Phenotype. Before that, I didn’t even know I had this rare blood and only one in India,” he said.

Autologous blood transfusion (originating from the recipient rather than from a donor) is usually selected for patients with a rare blood group or having antibodies that make it difficult to find compatible blood units.