Experience in Centralized Individual-Donor Nucleic Acid Testing (ID-NAT) for Blood Donor Molecular Amplification-Based Infectious Marker Screening.

The fragmented nature of Indian blood banking system can be drawn from the fact that we have 4153 licensed blood banks, catering to world's second largest population. Only few hundred blood banks have adopted new technologies like Nucleic Acid Testing (NAT) in India. This article tries to address the advantages of centralized testing for implementation of Individual Donor NAT (ID-NAT) and validates it with our own experience at a tertiary center in North India. As part of National health Mission (NHM, Govt. of India) initiative we have enrolled for ID-NAT testing at centralized testing center situated approximately at a distance of 350 km from our center, to provide safest possible blood to our patients. The ID-NAT testing is carried out using fully Automated Procleix Panther System using Procleix Ultrio Elite Assay for HIV-1&2 RNA, HCV RNA and HBV DNA. Starting from July 2019, 76,996 blood samples have been tested till December 2022. In this period, 242 ID-NAT-Yield cases, with an ID-NAT Yield rate of 1:318, have been interdicted, which could have transmitted infections to almost 616-924 patients through different blood components. Among these 242 ID-NAT Yields, 01 was HIV, 24 were HCV, 194 were HBV and 23 were HBV-HCV dual infections. This article affirms that in Indian scenario, Hub and Spoke model of centralized ID-NAT testing on regional to national level is the most cost-effective approach to provide every patient with the safest blood.