A Strategic Approach to the Problems of Providing Rhesus D–Negative Blood Transfusion in Geographic Areas With Low RhD Negativity: A Nigerian Perspective
Section snippets
Autologous Blood Donations
Autologous blood donation and transfusion have not yet been given the level of attention it deserves in Nigerian hospital blood banks, and the autologous blood procedure is largely restricted to the elites in whom the main motivation is the avoidance of transfusion transmissible infections.8 A rational approach toward solving the problem of RhD-negative blood scarcity in the hospital setting would be to scale down the number of requests for RhD-negative allogeneic blood through a process of
Inter–Blood Bank Transfer of RhD-Negative Blood
Most RhD-negative patients that require RBC transfusions would not qualify for autologous transfusion. Moreover, clinical experience had shown that most requests for RhD-negative blood are for emergency cases that need blood urgently, and only a few, 0.95% to 8%, of such patients would be Du-positive.4, 14, 15 We must therefore find ways of dealing with requests for RhD-negative patients that are neither eligible for autologous transfusions nor Du-positive. However, the hard reality in Nigeria
Cryopreservation of RhD-Negative Blood
The frequency of RhD negativity among Nigerian blood donors ranges from less than 1% to about 6%.3, 4, 5, 6 Therefore, a similar proportion of voluntary donor blood that is donated in Nigeria would be RhD-negative. However, it must be appreciated that such RhD-negative blood donations come randomly, sporadically, and in single units that are usually interspersed by several weeks. Blood banking experience in Nigeria had shown that on several occasions over the period of a year, such randomly
The Nigerian National Blood Transfusion Service
The decision to establish a sustainable National Blood Transfusion Service in Nigeria was conceived in 1975 at the World Health Assembly.37 However, since the signing and adoption of the World Health Assembly resolution in 1975, very little has been done by successive Nigerian governments to achieve the objectives of establishing a National Blood Transfusion Service that could be comparable to what is available in the developed countries of the world. Consequently, the Nigerian Blood
Conclusions
The solution to the problems of RhD-negative donor blood scarcity in Nigeria should be through a multifaceted approach that includes autologous donations, Du testing, inter–blood bank transfers, voluntary RhD-negative donor recall, family donations, and cryopreservation. In addition, there is an urgent need for upgrading and optimizing the capabilities of the Nigerian National Blood Transfusion Service.
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High prevalence of serological weak D phenotype and preponderance of weak D type 4.0.1. genetic variant in a Nigerian population: implications for transfusion practice in a resource-limited setting
2022, Hematology, Transfusion and Cell TherapyCitation Excerpt :Even though preventable with prophylactic administration of anti-D immunoglobulin, the cost and availability of the drug in low-income countries can sometimes be prohibitive. Serological typing of RhD negative individuals for the presence of the weak D type and subsequent molecular genotyping of weak D positive individuals could reduce the scarcity of RhD negative red cells by ensuring that weak D positive individuals are transfused with RhD positive red cells, thus conserving RhD negative red cells for individuals that are truly RhD negative.5 It will also prevent the unnecessary and costly administration of anti-D immunoglobulin to weak D positive women after the delivery of RhD positive babies.5
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