Bombay blood group for pediatric cardiac surgery in the era of a pandemic: Newer challenges call for desperate measures!

Bombay blood group is one of the rarest blood types with a prevalence of 1 per 10,000 population in India. Children and adults of this blood group can receive autologous blood or blood from an individual with a Bombay phenotype only. Children with grown-up uncorrected cyanotic heart disease are associated with a high risk of perioperative hemorrhagic diathesis and may require multiple blood transfusions. Arrangement of adequate Bombay blood group units for pediatric cardiac surgery is a unique challenge. The COVID-19 pandemic brought about additional difficulties in the procurement of blood components due to donor hostility. Despite the associated risks, pre-operative multi-session autologous blood harvest under monitored anesthesia care was planned in a 16-year-old child and four units of autologous blood were harvested and preserved for performing total correction surgery.