Hunt for Extremely Rare Blood Type Goes Global

When Daina Bautista needed life-saving heart surgery, the hunt for a match to her extremely rare blood type had to go global. But when international reserves weren’t enough, the team at Cleveland Clinic Abu Dhabi turned to the complex ‘self-donation’ technique.

It was in 2018 that Daina, a working mother from the Philippines who has lived in Abu Dhabi for more than 15 years, first began to suspect something was wrong. Her coughing fits were first diagnosed as asthma, but follow-up scans later revealed that three valves in her heart were damaged. By 2020, her condition had deteriorated significantly.

Daina says, “At first, I was able to live my life as normal. I knew something was wrong, but I wanted to focus on my work and family. Eventually, I couldn’t walk for more than a few minutes without losing my breath and everyday tasks became very hard. I knew it was time to go back to the doctor and finally get my heart fixed.”

Extremely rare blood type

Daina was booked for surgery at an Abu Dhabi hospital, but it was cancelled at the last minute as they were unable to find a blood match for her. Blood reserves are an essential part of any surgery, and procedures cannot go ahead without them.

Given the complication, her case was transferred to Cleveland Clinic Abu Dhabi. The Transfusion Medicine Pathology team performed extensive testing on Daina’s blood, which revealed not only was she the rare type B+, found in around only 9% of the population, but she also lacked the JK3 protein – an extremely rare phenotype. Any potential donor had to match both her blood type, and lack that specific protein.

Dr. Manuel Algora, a clinical pathologist and director of Cleveland Clinic Abu Dhabi’s blood bank says, “As soon as we discovered that Daina’s blood lacked the JK3 protein, coupled with her uncommon blood type, something that is exceptionally rare, we began our search for donors within the UAE and abroad. For her life-saving surgery to take place, we would need at least six units of blood.”

Searching for a blood-match

Dr. Algora’s team began working with Abu Dhabi Blood Bank to find suitable donors, and also tested Daina’s relatives. A compatible donor was found in Abu Dhabi who could donate one of the six units needed for the surgery. However, as blood donors can only give blood every eight weeks, the team had to widen the search across the Gulf region, and as far afield as Malaysia and Spain. Eventually, two units of matching blood were found in Kuwait.

While managing the logistics of importing the blood was underway, the team worked with Abu Dhabi Blood Bank to collect four units of blood from Daina herself.

“Although we had a local donor, and two units coming from abroad, we still needed four more units to safely perform the surgery. Collecting that much blood from the local donor would have taken months. As Daina had strong hemoglobin we were able to administer treatment to boost her red blood cell production so that she could safely self-donate”, adds Dr. Algora.

Under close medical supervision at Cleveland Clinic Abu Dhabi’s Infusion Center, Daina gave four units over a 3-week period so that the hospital would have enough blood and her surgery could go ahead.

“Blood is the foundation of modern surgery. If we can’t replace blood lost during surgery, many simple surgeries we take for granted today simply could not happen. Even with minimally invasive surgery, it is vital that we have blood on hand to ensure patient safety. When I heard we had the blood needed to repair Daina’s heart valves I was thrilled. We could finally move ahead and get her back to living a full life,” says Dr. Umer Darr, the heart surgeon who led Daina’s surgery.

Daina’s surgery finally took place, more than 3 months after it was initially scheduled. Although the search for blood had caused a significant delay, Daina made a swift recovery following her surgery and was discharged just over 2 weeks later.

Daina says, “I am so grateful to Dr. Algora and Dr. Darr for everything they have done for me. Although it was stressful, I always felt safe and cared for at Cleveland Clinic Abu Dhabi. I can hardly believe the effort everyone made to find the blood I needed. It has really opened my eyes to the importance of blood donation and what a beautiful gift it represents.”

Dr. Algora adds, “This was a very difficult case and I’m very proud that we were able to come together as one team to arrange for the import of the blood Daina so desperately needed. Fortunately, we have a fantastic relationship with Abu Dhabi Blood Bank, the Ministry of Health and Prevention, and the international blood transfusion community. When we spoke to colleagues in other countries, they understood the challenge and did everything they could to help. Without the support of our local and international partners, this could not have happened.”

Cleveland Clinic Abu Dhabi holds regular blood donation events for its caregivers in partnership with Abu Dhabi Blood Bank, which collects hundreds of units of blood each year to offer life-saving care across the UAE.