The prevalence of G6PD deficiency in blood transfusion recipients

G6PD deficiency is the most common metabolic disorder of red blood cells, involving about 35 million people worldwide. Tropical and subtropical regions in the eastern hemisphere have the highest prevalence, up to 35% in some areas. The prevalence varies in different parts of the world. According to WHO, there is a 10-14.9% prevalence of G6PD deficiency in Iran. With this high prevalence, blood products are not still checked for G6PD deficiency. So, they may be used for transfusion in neonates with jaundice or for patients using oxidants. In this cross-sectional study, we have observed the effects of using this kind of blood in patients receiving blood in the Pediatric and Neonatology Departments of Imam Sajjad's Hospital in Yasuj. Samples were taken from 261 blood bags used for transfusion or exchange, and examined by spot fluorescence for G6PD deficiency. All of the patients receiving blood were examined for hemoglobin, hematocrit, and bilirubin before and after transfusion. They were also examined for hemoglobinuria, factors involved in hemolysis due to G6PD deficiency, and oxidants.

From the 261 blood transfusions, 37(14.17%) blood bags had G6PD deficiency. About 81% of these transfusion recipients had at least one risk factor for hemolysis. The complications associated with receiving these red cells were: insufficient rise in hemoglobin (55.9%), hemoglobinuria (35.3%) and rise in bilirubin (8.8%), which were significantly higher than the control group.

Considering the high prevalence and complications of transfusing G6PD deficient blood to high risk patients, it is recommended that in the form used for requesting blood products, there should be a place for checking G6PD enzyme so that the physician requesting blood could request the test to be done, depending on the risk factors.