Every year, India requires an estimated 14.6 million units of blood – a figure that reflects the scale and urgency of healthcare needs across the country. Yet, beyond this broad demand lies a far more complex and often overlooked challenge: patients who need not just blood, but rare and highly specific matches to survive.
As highlighted by a 2023 study“patients who require blood from rare blood group donors present great challenges even to the most advanced healthcare delivery system.” The difficulty is not just about availability, but compatibility. For patients with antibodies to high-prevalence antigens, finding a matching donor can be extraordinarily rare – sometimes occurring in less than one in 1,000 individuals. In such cases, even a well-functioning blood supply system can fall short.
Globally, mechanisms like the International Rare Donor Panel have existed since 1965 to address such gaps. However, South Asian countries, including India, remain underrepresented in these networks. The same study notes that despite scientific progress, India continues to face multiple barriers – from limited awareness and lack of antibody screening to inadequate genotyping facilities and a fragmented transfusion system. While initiatives like e-RaktKosh and collaborations with groups such as the Indian Red Cross Society are improving donor registration and awareness, the ecosystem still has loopholes.
The challenge becomes even more pressing when seen alongside overall demand-supply dynamics. A national-level study analysing 251 health facilities found that India’s clinical demand translates to 36.3 donations per 1,000 eligible population, while supply stands at 33.8 donations, leaving a gap of nearly one million units annually. The study concluded that this shortfall underscores the need for “sustained and concerted efforts from all stakeholders,” including improving voluntary blood donation, strengthening infrastructure, and enhancing human resource capacity.
While this gap is concerning, it becomes critical for rare blood groups, where delays can be life-threatening. To understand this better, we spoke to Dr. Revanth BodduConsultant – Haematology, Hemato-Oncology & Bone Marrow Transplant, Aster Whitefield Hospital.
What qualifies as a rare blood group in India?
Dr Revanth Boddu explained that a blood group is defined as rare when its occurrence drops below 1 in 1,000 people within a specific community. The common blood types A, B, AB, and O exist in abundance, but rarity emerges through specific antigen presence or absence beyond the basic ABO and Rh systems.
He noted that the Bombay blood group and other such phenotypes in India are extremely rare, as “individuals with this condition lack the H antigen and cannot use any of the existing blood types.” India’s diverse population, with varied ethnic and genetic backgrounds, contributes to multiple rare variants—making matching more complex.
How are rare donors tracked and contacted?
Dr Boddu said that due to limited centralised systems, blood banks and transfusion centres operate their own donor registries. These databases contain records of individuals with rare blood types identified through routine screening and specialised tests.
He explained that registered donors are educated about their importance and kept accessible for emergencies. Hospitals also collaborate with blood banks, non-profits, and informal donor networks to locate suitable donors. Digital platforms and mobile-based databases are increasingly being used to speed up the process, as timely identification remains critical for patient safety.
Are there national or global registries?
Dr Boddu noted that India is gradually developing structured systems for rare blood group management. Organisations like the National Blood Transfusion Council support efforts to standardise blood banking practices and improve donor tracking, while advanced centres maintain and share rare donor registries.
At the global level, the International Society of Blood Transfusion facilitates collaboration through international registries. However, he pointed out that “these networks, while helpful, are often limited by time and logistical challenges during emergencies.”
Challenges faced by patients with rare blood groups
Dr Boddu highlighted that patients with rare blood groups face both medical and emotional challenges. The primary concern is finding compatible blood during emergencies such as trauma, surgery, or childbirth. He noted that “matching donors may make up less than 10 per cent of the population,” leading to severe shortages.
He added that low public awareness is another barrier, as many individuals discover their rare blood type only during a medical need. Maintaining updated donor databases is also difficult, as donors may relocate or become ineligible. Additionally, specialised storage facilities for rare blood are not uniformly available across India.
He further explained that coordination between hospitals, blood banks, and registries still needs improvement, with delays in communication, transport, and access, especially in remote areas, affecting timely transfusions.
Dr Boddu emphasised that improving management requires better testing, stronger donor registries, enhanced coordination, and increased public awareness. Early identification of rare donors and regularly updated databases can significantly improve emergency response times.
He concluded that while medical science continues to advance, rare blood groups remain a critical gap in transfusion care – one where preparedness, system efficiency, and awareness directly impact patient survival.
This story is done in collaboration with First Checkwhich is the health journalism vertical of DataLEADS
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