Blood Safety: The Madhya Pradesh Centralized Nucleic Acid Testing (NAT) Model for Blood Donor Screening

Area of Science:

• Transfusion Medicine
• Molecular Diagnostics
• Public Health

Background:

• Blood transfusion safety is critical in India, with serological screening alone insufficient to detect early infections.
• Centralized nucleic acid testing (NAT) presents an advanced molecular diagnostic approach to bolster blood safety.

Purpose of the Study:

• To evaluate the successful implementation of a centralized NAT hub-and-spoke model in Madhya Pradesh.
• To assess the model's impact on enhancing blood transfusion safety in the region.

Main Methods:

• A public-private partnership (PPP) utilized a hub-and-spoke model for centralized NAT.
• Retrospective analysis of program data from January 2023 to September 2024.
• 24 satellite blood centers' deidentified records processed at central hubs using Roche cobas® TaqScreen MPX test (version 2.0).

Main Results:

• Out of 158,493 seronegative samples, 943 (1 in 168) were NAT-reactive, indicating infections missed by serology.
• The model potentially prevented 2829 transfusion-transmitted infections.
• A consistent 48-hour turnaround time was maintained, and operational challenges were overcome.

Conclusions:

• The Madhya Pradesh centralized NAT model is a feasible, effective, and efficient strategy for improving blood safety.
• This model offers a replicable framework for developing countries aiming to enhance transfusion medicine practices.