Letters to the Editor
Suchet Sachdev, Lakhvinder Singh, Ratti Ram Sharma, Neelam Marwaha Department of Transfusion Medicine, PGIMER, Chandigarh, India
Donor hemovigilance: Delayed vasovagal reaction with injury in a blood donor Sir, We report a case of delayed vasovagal reaction in a 19-year-old male blood donor of severe grade and definite imputability as per the classification of working group on complications related to blood donation (International Society of Blood Transfusion working party on Hemovigilance and European Hemovigilance Network, 2008) in a blood donor qualifying the blood donor selection criteria as per the standard operating procedure of our department based on the Drugs and Cosmetics Act of India. The blood donor was brought back to the donation venue 1½ h post blood donation by his colleagues. The donor was found to be responsive and reported that he was sitting in the garden adjoining hostel and consequent upon standing in order to walk to his room, experienced light headedness, profuse sweating and then fainted. On examination, the pulse rate was 62/min, regular and blood pressure of 110/68 mm of Hg. There was no h/o of projectile vomiting, no nystagmus. The left thumb was swollen and painful, which is consistent with a post blood donation delayed vasovagal loss of consciousness, followed by fall. Closed reduction with k-wire fixation of base of distal phalanx was done after X-ray [Figure 1]. Donor was asymptomatic; the nail bed showed early new nail recovery on follow-up. The donor hemovigilance arm of a national hemovigilance system should be based on standardized reporting formats and review initiatives being implemented to reduce adverse reactions. Reporting, monitoring and evaluation of blood donor reactions and the outcome of interventions could help generate evidence for formulating strategies that could have an impact to decrease adverse donor reactions in order to retain willingness to donate blood. [1]
Acknowledgment We sincerely regard the support received from the Department of Plastic Surgery and Radio Diagnosis and Imaging during the management of the blood donor.
Figure 1: Pre and post K-wiring of left distal phalaynx 104
Correspondence to to: Dr. Suchet Sachdev, Department of Transfusion Medicine, PGIMER, Chandigarh, India. E-mail: [email protected]
Reference 1.
Donor vigilance – What are we doing about it? Available from: h ps:// www.openaccess.leidenuniv.nl/bitstream/handle/1887/20625/02. pdf?sequence=7. [Last accessed on 2013 Dec 04]. Access this article online
Website: www. ajts. org
Quick Response Code:
DOI: 10.4103/0973-6247.150972
Undetermined blood loss due to accidental injury and its management in a male patient of classical Bombay (Oh) phenotype in a hospital in the remote part of east India Sir, Absence of A, B, and H antigen on red cell surface, commonly known as Bombay (Oh) phenotype, is an extremely rare blood group type as it is found in 1 in 10,000 individual in India and 1/1,000,000 individuals in Europe.[1] The presence of anti-H antibody in the serum of Oh phenotype makes the transfusion of identical Oh phenotype blood necessary in such patients.[2] Bombay phenotype can be either classical Bombay or para-Bombay, with classical Bombay phenotype more common in India.[3] Characterization of Bombay phenotype in the recipient as well as in donor is extremely important for transfusion management. Furthermore, recipients requiring multiple units of Oh blood during an emergency, as the case mentioned here, can be a challenge for transfusion service providers. A 25-year-old male patient presented to the emergency department due to inability to transfuse cross match compatible blood elsewhere. Laboratory investigations revealed requirement of 3 units of Oh blood urgently. Pretransfusion testing in the form of blood grouping and antibody screening indicated recipient to be Oh phenotype. Further testing with anti-H lectin and saliva testing confirmed the recipient to be of Oh phenotype. Direct coomb’s Asian Journal of Transfusion Science - Vol 9, Issue 1, January - June 2015
Copyright of Asian Journal of Transfusion Science is the property of Medknow Publications & Media Pvt. Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Suchet Sachdev, Lakhvinder Singh, Ratti Ram Sharma, Neelam Marwaha Department of Transfusion Medicine, PGIMER, Chandigarh, India
Donor hemovigilance: Delayed vasovagal reaction with injury in a blood donor Sir, We report a case of delayed vasovagal reaction in a 19-year-old male blood donor of severe grade and definite imputability as per the classification of working group on complications related to blood donation (International Society of Blood Transfusion working party on Hemovigilance and European Hemovigilance Network, 2008) in a blood donor qualifying the blood donor selection criteria as per the standard operating procedure of our department based on the Drugs and Cosmetics Act of India. The blood donor was brought back to the donation venue 1½ h post blood donation by his colleagues. The donor was found to be responsive and reported that he was sitting in the garden adjoining hostel and consequent upon standing in order to walk to his room, experienced light headedness, profuse sweating and then fainted. On examination, the pulse rate was 62/min, regular and blood pressure of 110/68 mm of Hg. There was no h/o of projectile vomiting, no nystagmus. The left thumb was swollen and painful, which is consistent with a post blood donation delayed vasovagal loss of consciousness, followed by fall. Closed reduction with k-wire fixation of base of distal phalanx was done after X-ray [Figure 1]. Donor was asymptomatic; the nail bed showed early new nail recovery on follow-up. The donor hemovigilance arm of a national hemovigilance system should be based on standardized reporting formats and review initiatives being implemented to reduce adverse reactions. Reporting, monitoring and evaluation of blood donor reactions and the outcome of interventions could help generate evidence for formulating strategies that could have an impact to decrease adverse donor reactions in order to retain willingness to donate blood. [1]
Acknowledgment We sincerely regard the support received from the Department of Plastic Surgery and Radio Diagnosis and Imaging during the management of the blood donor.
Figure 1: Pre and post K-wiring of left distal phalaynx 104
Correspondence to to: Dr. Suchet Sachdev, Department of Transfusion Medicine, PGIMER, Chandigarh, India. E-mail: [email protected]
Reference 1.
Donor vigilance – What are we doing about it? Available from: h ps:// www.openaccess.leidenuniv.nl/bitstream/handle/1887/20625/02. pdf?sequence=7. [Last accessed on 2013 Dec 04]. Access this article online
Website: www. ajts. org
Quick Response Code:
DOI: 10.4103/0973-6247.150972
Undetermined blood loss due to accidental injury and its management in a male patient of classical Bombay (Oh) phenotype in a hospital in the remote part of east India Sir, Absence of A, B, and H antigen on red cell surface, commonly known as Bombay (Oh) phenotype, is an extremely rare blood group type as it is found in 1 in 10,000 individual in India and 1/1,000,000 individuals in Europe.[1] The presence of anti-H antibody in the serum of Oh phenotype makes the transfusion of identical Oh phenotype blood necessary in such patients.[2] Bombay phenotype can be either classical Bombay or para-Bombay, with classical Bombay phenotype more common in India.[3] Characterization of Bombay phenotype in the recipient as well as in donor is extremely important for transfusion management. Furthermore, recipients requiring multiple units of Oh blood during an emergency, as the case mentioned here, can be a challenge for transfusion service providers. A 25-year-old male patient presented to the emergency department due to inability to transfuse cross match compatible blood elsewhere. Laboratory investigations revealed requirement of 3 units of Oh blood urgently. Pretransfusion testing in the form of blood grouping and antibody screening indicated recipient to be Oh phenotype. Further testing with anti-H lectin and saliva testing confirmed the recipient to be of Oh phenotype. Direct coomb’s Asian Journal of Transfusion Science - Vol 9, Issue 1, January - June 2015
Copyright of Asian Journal of Transfusion Science is the property of Medknow Publications & Media Pvt. Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
