Background D antigen is one among the most immunogenic antigens and is the most common cause of Haemolytic Disease of Fetus and Newborn (HDFN). The D‐phenotype is a rare Rh variant in which none of the RhCE antigens are expressed on the red cell surface. Individuals having D‐phenotype are capable of producing a rare alloantibody named as anti‐Rh17(Hr°) in response to pregnancy or transfusion and has the potential to react with C/c and E/e antigens causing severe haemolytic transfusion reaction (HTR) and haemolytic disease of fetus and newborn (HDFN). Case report We have encountered a case of severe HDFN with an accidental discovery of D‐ phenotype of the mother with anti‐Rh‐17 antibodies. D‐ phenotype has been confirmed with molecular typing along with genotyping of all family members. Conclusion Rare phenotypes like D‐ individuals especially if allo‐immunised are of great concern at times of transfusion requirements. Hence, proper identification of these individuals are important to contribute them to the rare donor pool and to adopt adequate patient blood management strategies.

Background and Objectives: Hemovigilance is defined as a set of surveillance procedures covering the whole transfusion chain that is intended to collect and assess information on unexpected or undesirable effects resulting from the therapeutic use of labile blood products and to prevent future occurrence and recurrence. The primary goal of the study was to reduce the incidence of adverse events among blood donors and to make blood donation a pleasant experience. Prevention of adverse reactions at the time of blood donation is an important aspect of blood donor motivation and blood donor retention for future blood donations. Methods: This is a one and half year's prospective study which was conducted by the department of Transfusion Medicine. The study assessed untoward blood donor reactions, as a measure to further maximize the elimination of untoward reactions encountered during or after blood donation to secure a healthy donation-transfusion chain. We analysed the causative factors that can lead to complications in blood donors at different phases of blood donation like pre-donation, during donation and post donation phases. Results: Out of 8180 whole blood collections, 252 blood donor complications were observed during the study period. Out of this, 8.73% (n=22) adverse reactions were observed during donation at blood centre, while 91.27% (n=230) reactions occurred in blood donation camps. Among the camp donations, 61.30% (n=141) were at outdoor camps and 38.70% (n=89) were inside Blood Mobile. We had 83.23% (n=6808) of male blood donors and 16.77% (n=1372) of female donors. Out of the 66 females who developed complications, majority were belonging to the age group of 18-25 years. We had 37.90% (n=3100) first time donors and 62.10% (n=5080) repeat donors. Among the repeat donors, 34.59% (n=1757) were regular repeat donors and 65.41% (n=3323) were irregular repeat donors. Out of 130 first time donors who developed complications, 91.5% (n=119) were systemic reactions. 57.1% (n=12) of regular repeat donors and 80.2% (n=81) of irregular repeat donors developed systemic complications. Conclusion: Hemovigilance reporting has reinforced our blood donor safety as well as transfusion safety. Regular reporting of the adverse donor complications helped us to improve proper documentation of all aspects of a complete blood donation sequence not only by the medical officers but also by the blood centre staff members.

Background: The blocking of D antigen sites of RBC membrane of the fetus by the passively transferred IgG anti-D in cases of Hemolytic Disease of fetus and new born (HDFN) is called blocked- D phenomenon. The coating of maternal IgG type of anti-D prevents the agglutination of the Rh-(D) antigen positive red blood cells (RBC) by the IgM D-antigen typing reagents. We are reporting two cases of Rh-(D) HDFN which were falsely typed as Rh (D) antigen negative with routine typing reagents and had multiple allo-antibodies in the maternal serum. Aims: To rule out HDFN and to confirm the Rh-(D) status of baby, to detect the presence of other allo-antibodies in the maternal serum that can complicate future transfusions in mother. Materials: After routine blood grouping, sample of baby was subjected to adsorption-elution studies and maternal serum was used for antibody screening and identification Results: In both the cases, blocked-D phenomenon got detected and there were multiple anti-rhesus antibodies other than anti-D in the maternal serum. Conclusion: Antibody identification in antenatal women is important in the case management of HDFN to protect future pregnancies and to avoid the risk of mismatched transfusions.

No abstract