The Rare Lifeline: Struggle and Strategy Behind O_h (Bombay) Blood Group Transfusions Open Access

1. The case depicts the management of rare blood group [O_h(Bombay)] emergency transfusion support in postoperative oncology patient.

2. The case highlights the need to establish a well-organized rare blood group donor registry as well as streamline procurement process.

The O_h(Bombay) blood group is a rare autosomal recessive gene characterized by absence of H-antigen, severely restricting transfusion options due to scarce compatible donors. A 61-year female with advanced endometrial cancer and rare O_h(Bombay) blood group faced significant transfusion challenges due to postoperative complications and scarcity of blood components. Despite exhaustive efforts, including rare donor mobilization and transfusion of multiple blood components, securing O_h(Bombay) units remained a significant and persistent challenge throughout the course of management. This case emphasizes the urgent need for structured registries, coordinated logistics, and expert strategies in rare blood group transfusion care.