Department of Immunohematology and Blood Transfusion

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Designing and assessing the impact of a competency-based training program in transfusion medicine among MBBS interns
(SCOPUS, 2025) Manish Raturi; Yashaswi Dhiman; Naveen Bansal; Basanta Khatiwada; Dushyant Singh Gaur; Poonam Rawat
Introduction: It has been widely recognized that there is a pressing need to strengthen transfusion medicine education for both undergraduate and postgraduate medical trainees across various clinical specialties to enhance patient safety. In response to this, the National Medical Commission (NMC) of India implemented a competency-based medical education (CBME) framework in 2019 for undergraduate MBBS students across all medical colleges in the country. The present study aimed to assess the impact of a training program designed for medical interns, developed in alignment with the CBME curriculum prescribed by the NMC. Materials and methods: This was a questionnaire-based cross-sectional study conducted among MBBS interns undergoing rotatory training in different departments of a tertiary care teaching hospital. A structured two day educational program was organized, comprising six modules—three focusing on bedside transfusion practices and three addressing blood donation and laboratory-based transfusion medicine. Each module was designed to reflect the competencies outlined in the CBME curriculum and included pre- and post-training assessments to evaluate knowledge improvement. A pre-test was conducted to assess the knowledge of transfusion medicine among the participants and the post-test was conducted to assess the impact of the training program. Results: Overall, the pre-test score in the present study was 14.1 (47%) which increased to 22.3 (77.6%) in the post-test. Analysis of the pre-test scores showed that 80% of the interns had weak knowledge of blood transfusion reactions and its management. 55.6% of the interns had weak knowledge of indications of blood component therapy whereas 32.2% of the interns had weak knowledge of bedside transfusion medicine practices. 73.3% of the interns had weak knowledge of blood donor selection and counselling. 62.3% of the interns and 73.3% of the interns had weak knowledge of transfusion transmitted infections and basic blood banking including compatibility testing and storage conditions for various blood components, respectively. Post-training results showed a significant improvement across all domains. Effect size analysis using Cohen’s d indicated that the training program was highly effective in five out of six domains, with moderate effectiveness observed in the domain of immunohematology. Conclusion: Although transfusion medicine knowledge is essential for routine practice in core medical and surgical specialties, a substantial knowledge gap exists among medical interns. This study demonstrates that a structured, CBME program is an effective strategy to improve transfusion medicine knowledge among MBBS interns
Improvising neonatal thrombocytopenia management: Insights from split, volume-reduced, single-donor apheresis platelets (NeoVRs-SDAP)
(Wiley, 2026) Dhiman, Yashaswi; Patra, Saikat et al.
Introduction: Thrombocytopenia is common in neonates, managed with platelet transfusions at defined dose. The product type varies from neonatal-specific units using platelet additive solutions to adult products split into multiple paediatric units. In low-middle-income countries, whole blood-derived random donor platelets (RDP) are common while western countries use split adult single donor apheresis platelets (SDAP). We aimed to assess preliminary effectiveness of split, volume-reduced single donor apheresis platelets (NeoVRs-SDAP) in neonatal thrombocytopenia and observe early post-transfusion outcomes. Methods: Study was conducted from August 2024 to January 2025 at a tertiary healthcare centre. Persistent thrombocytopenic neonates admitted to the NICU were transfused with NeoVRs-SDAP prepared using Spectra Optia® with modified pro gram yielding an adult dose (300 109) in a reduced 100 mL of product volume. These were split into 2–5 aliquots for transfusion. Post-transfusion platelet incre ments and percentage recovery were assessed after 20–24 h. Results: Thirteen neonates' 77% preterm, 69.2% VLBW with sepsis received 46 NeoVRs-SDAP. 10 mL of this product contained nearly 3 times more platelets than RDP and 1.5 times more than adult SDAP of same volume. The mean transfused dose was 70.56 ± 14.21 109 platelets. Median platelet increment was 64 500/μL versus 15 477/μL for RDP (p < 0.001). Platelet recovery ranged from 7.5%–52.5%. Split products reduced donor exposure by 56.5%. Survival was 62%, without any transfusion-related adverse events. Conclusion: NeoVRs-SDAP may be potential alternative in persistent neonatal thrombocytopenia, offering better increments and recovery, reduced donor expo sure, and leukoreduction. Further RCTs comparing NeoVRs-SDAP and RDP are recommended.
The Crimson Laureate’s vision: Establishing a Paw Blood Bank for all creatures great and small
(Elsevier, 2026-02-01) Raturi, Manish; Paudel, Purshotam
The Crimson Laureate envisions setting up an animal blood bank in North India, where science and compassion would unite to save animal lives. A systematic journey from ancient transfusion beliefs to modern veterinary transfusion science is discussed. There is a promise of species-specific, infection-screened blood availability for all the creatures great and small.
Comprehensive Evaluation of Pooled Red Blood Cell Saline Suspensions Used in Routine Blood Typing: A Resource Optimisation Laboratory-Based Study
(Elsevier, 2026-05) Raturi, Manish; Gaur, Dushyant S. et al.
Preparation of 2–5% pooled A, B, and O red cell suspensions (RCS) in 0.9% normal saline (NS) is a routine and essential practice in most blood centres to ensure accurate reverse/plasma testing while performing ABO and Rh(D) blood typing [1]. These standardized RCS form the backbone of immunohematology (IH) testing because of their consistent antigen expression, reproducibility, and minimal background reactivity [2,3]. Despite their widespread use, the requirement to prepare RCS fresh each day is both labour intensive and resource-consuming, particularly in high-volume transfusion laboratories. Current literature offers limited data on the biological and functional stability of 5% pooled RCS stored under controlled refrigeration [4]. Evidence-based guidance on safe reuse duration is lacking, even though such a protocol could substantially reduce workload, reagent consumption, and operational costs without compromising test accuracy. This study, therefore, primarily aimed to determine the stability and reusability window of 5% pooled RCS prepared in 0.9% NS when stored at 4 ± 2°C. Secondary objectives included assessing agglutination strength, hemolysis, pH changes, red cell morphology, and sterility over the storage period to establish a scientifically validated reuse protocol for routine IH laboratories.
Hematological and leukocyte morphometric indices as low-cost diagnostic adjuncts in acute coronary syndromes
(2026-05-02) Mehrotra, Mansi; Gaur, Dushyant Singh et al.
Objective Acute Coronary Syndromes (ACS) remain a major cause of morbidity and mortality, particularly in resource-limited settings where access to advanced diagnostics may be constrained. This study aimed to evaluate the utility of routine hematological indices and leukocyte morphometric parameters—volume, conductivity, and scatter (VCS)—as low-cost adjuncts for identifying ACS and differentiating its subtypes. Results description This cross-sectional study included 291 adults (151 ACS patients and 140 healthy controls) evaluated between January 2022 and August 2023. Compared with controls, ACS patients had significantly higher total leukocyte counts, lower hemoglobin levels, increased mean platelet volume (MPV), reduced neutrophil conductivity (MN-C-NE), and increased monocyte scatter parameters (MN-LALS-MO, MN-AL2-MO) (all p < 0.01). On L1-regularized multivariable logistic regression, elevated WBC count, reduced hemoglobin, increased MPV, decreased neutrophil conductivity, and increased monocyte scatter indices independently predicted ACS. The combined model demonstrated excellent discriminatory performance (AUC 0.98 ± 0.02). However, discrimination between ACS subtypes was limited, with poor performance for differentiating STEMI from unstable angina and NSTEMI (AUC 0.63–0.65, p > 0.05). These findings suggest that hematological and VCS parameters are effective for identifying ACS but have limited utility in subtype differentiation.