Written By: Pavitra Sampath | Updated : May 22, 2014 1:25 AM IST
Recently, a 36-year-old woman called Rukmini from Sakleshpur recently underwent an open heart surgery at Mangalore, a city which is quickly becoming renowned for its medical marvels. While an open heart surgery is a intricate affair, this was even more complicated because Rukmini has a blood group known as the Bombay blood group,the hH or the OH blood group.
Why was this case so rare?
Reports say that Rukmini suffered from a congenital heart condition that required her to get open heart surgery. Although all open heart surgeries are done with the patient under general anaesthesia, doctors soon discovered a marked decrease in her lung function, eliminating the possibility of general anaesthesia. They opted to perform an open heart surgery while she was awake, and although this type of surgery has been done the world over, it is usually fraught with danger for the patient. The most significant danger is blood loss (the only thing more serious is that the heart not restarting) which necessitates a blood transfusion after the surgery. In Rukmini's case, this risk was even higher because she shares her blood group with only 0.0004% (about 4 per million) of people in the world (according to Wikipedia).
What is the Bombay blood group?
We all have either A, B or O blood groups. This means that we have a specific antigen to a type of blood group and antibodies against a particular blood group. For example, a person with A blood group has antigens of type A and anti B antibodies (fighter cells that form a sort of clot when they come in contact with the type of blood they are against i.e. B group); vice-versa for a person with blood group B. People with O blood group have antibodies against both A and B groups. What we don't realise is that we all have an antigen called H antigen. We all have this H antigen in our blood with no antibodies against it. In the case of people with the Bombay blood group they do not have any antigens; they only have anti-A, anti-B and anti-H antigens in their blood. Therefore if any type of blood was administered to them they would die instantly as their blood would attack the new blood given to them leading to a condition called acute haemolytic transfusion reaction.
Blood Groups (Antigens and Antibodies) | ||
Blood Group | Antigens | Antibodies |
A | A,H | B |
B | B,H | A |
AB | A,B,H | - |
O | H | A,B |
Bombay Blood Group | - | A,B,H |
What tests are done to detect it?
In most places that test for a person's blood group, check for the presence or absence of the AB and Rh alone. Since people with the Bombay blood group do not have either of the blood groups, they are categorised as having blood group O. Only when they are tested for the presence or absence of the H antigen can their blood group be confirmed. Tests like serum grouping or reverse grouping are used to test for the presence of the H antigen. (Read: Blood tests: Understanding the different kinds)
Who can have it?
This group was first discovered in people living in Bombay and that is why it was named the Bombay blood group. This anomaly usually arises due to a genetic defect, where a person carries the recessive gene. It is mostly seen in East Indians, Japanese and Caucasians though it's extremely rare in these groups as well. People with type O blood should ideally get tested for the Bombay blood group. And if detected with it they should get their family also tested, as it is very likely that one of them also suffers from the same anomaly. (Read: Take the natural route to heart health home remedies that work!)
Read more about causes, symptoms, diagnosis and treatment of heart disease.
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