Managing blood requirement in a rare P-null phenotype patient during the COVID pandemic in a resource-limited setting.

We report the case of a 5-year-old girl with a rare P-null phenotype who presented for a neurosurgical procedure at our center. The case is unique as this patient was one of the two P-null phenotype cases reported in India and we report how we could successfully arrange a rare blood unit for her. As it was challenging to find a donor for her, autologous blood was collected. Despite iron supplementation and erythropoietin injections, her hemoglobin remained low and the required number of autologous units could not be collected. As a consequence of the search initiated with the international and regional rare donor registries, a donor was identified in a remote village in India. Despite the logistic hurdles due to the COVID pandemic, the blood could be transported safely for performing the surgery. A centralized database of rare donors needs to be established to meet such requirements.