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Ahmedabad: An older man, around 65 years from Rajkot, was in for a wonder when he could not find blood to match his blood type for heart surgery in 2020. The surprise was compounded by his known blood type being positive AB, the universal acceptor. His long struggle eventually led to the discovery of India’s first EMM-negative blood case – the 11th case in the world.

The article “Anti-emm, a rare Emm antigen specificity with a high incidence in an Indian patient, definition a new EMM blood group system (ISBT042)” was published in the Asian Journal of Transfusion Science by Ripal Shah, Snehal Sendjalia, and Sanmukh Joshi among others. Dr. Reepal Shah, director of Pratam Blood Bank in Ahmedabad, said when no matching blood was found in Rajkot’s blood banks, the patient arrived in Ahmedabad with the same result. “He needed it for coronary artery bypass surgery. Antibodies in the blood reacted in the physiological phases and the antiglobulin phase. Even the blood from his child did not match his,” she said.

The blood samples were sent to Surat for advanced analysis and eventually to a laboratory in the US. The results showed that there is no EMM phenotype in the blood. “It is present in almost all human red blood cells (erythrocytes). Thus, its absence made it difficult to compare with existing samples. Since the patient had no history of blood transfusion, this happened naturally. He has a similar blood type, but not the same,” said Dr. Shah, adding that in case of emergency, his brother can donate blood to him.”But the patient succumbed to other health complications.”

Rare Blood: What Makes the case unique

  1. The researchers said they are interested in studying family members to determine how they acquired the altered phenotype. But that will happen when the family comes to terms, they added.
  2. What happens when someone with this type is transfused with their known blood type? Experts said this could lead to an adverse reaction of the antigen and white blood cells present in the host, resulting in a severe reaction that can even lead to death.
  3. More than 376 group antigens have been recognized worldwide. The rest are classified into different series and collections.
  4. The experts said that identifying rare blood types will help them deal with such cases relatively quickly and, if possible, expand medical care.

What is EMM negative?

The Rajkot man is said to be the first person in India and tenth in the world with an EMM blood type. Because his EMM blood level is low, the International Society for Blood Transfusion (ISBT) labeled him EMM negative, and the blood group was designated ISBTO42.

EMM-negative people can’t donate.

People with an EMM-negative blood type cannot donate blood to anyone. They also cannot accept blood from anyone.

Experts say that if a person receives blood, even from a person belonging to the same group, the chances of a reaction inside the body increase many times over and can be fatal.

EMM antigens are antibodies produced naturally in the human body. There are nine people in the world with an EMM-negative blood type, and now 10 people from Gujarat have been added to this list.

Reepal Shah, medical director of the Pratam laboratory in Ahmedabad, said the patient has an AB+ blood group, which has been cross-checked with 40-50 samples available.

“We tried various methods available in India to match his blood, and I realized there was something strange about his blood. We also matched his blood with samples from his son and daughter. But that didn’t work either. So we sent another sample to New York.

“It took them over a year to reach a conclusion. The process has also been delayed due to the covid pandemic. In the meantime, the doctors gave him medicine to increase his hemoglobin levels. While the hemoglobin level rose, the patient could not perform the surgery, so the doctors postponed it. He also contracted Covid. He died a month ago of natural causes,” Shah said.

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