A Transfusion Medicine Fellow who is in training at a large university in the Midwest reports that their donor center discovered two individuals with "hemoglobin J variant" following a hemoglobin electrophoresis that was performed on a post-transfusion sample that was collected from a sickle cell disease patient. Two of the RBC units that the patient received had been donated by a pair of Caucasian sisters (ages 81 and 83 years old) who were of French, German and English decent. The exact subtype of HbJ is not known, since a sample was not sent out for DNA analysis, but the hemoglobin electrophoresis of the patient and of both sisters showed a HbJ pattern. The two sisters had donated many times (more than 15 each) in the past, without reports of complications or reactions in any transfusion recipients. Both sisters are generally healthy and have never had any symptoms attributed to their HbJ status. The inquiring Transfusion Medicine Fellow wonders if others have discovered similar donors, and if there is any reason to defer these sisters from making future blood donations.

The following comments have been received.

ADDENDA Dec. 14, 2005

1. The Technical Director of a Regional Community Blood Collection Center in Northern California reports that in his opinion, if a donor has a hemoglobin variant but normal hematological parameters and no history of chronic cyanosis due to lower than normal oxygen affinity curves, there would seem to be little reason to defer the donor. In the case under discussion, if the 80+ year old donors are healthy enough to pass the history and physical for blood donation, they have been served well by their J variant hemoglobin. The fact that they have a relatively uncommon hemoglobin variant is very interesting, but probably has no effect on the efficacy of the products collected from them.

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Ira A. Shulman, MD
CBBS e-Network Forum Editor & Moderator