Warfighters & Frontline Blood Products

Research Paper Title

Lifeline for the front lines: blood products to support the warfighter.


Haemorrhage is the leading cause of death on the battlefield.

Damage control resuscitation guidelines in the US military recommend whole blood as the preferred resuscitation product.

The Armed Services Blood Programme (ASBP) has initiated low-titer group O whole blood (LTOWB) production and pre-deployment donor screening to make whole blood more available to military forces.


ASBP donor centres updated procedures and labelling for LTOWB production. Donors are screened according to US Food and Drug Administration regulations and standard operating procedures.

Group O donors are tested for anti-A and anti-B titer levels.

Additionally, military personnel notified for pending deployment coordinate with their local ASBP donor centre to complete whole blood donor pre-screening.

The process consists of completing a donor history questionnaire, processing of blood samples for blood group and infectious disease testing, and titer determination for group O personnel.


Since March 2016, 7940 LTOWB units have been manufactured at ASBP donor centres and shipped in support of combat operations.

Additionally, ASBP donor centres have screened several thousand service members before deployment.

From these screenings, the donor low titer rate was 68% and infectious disease reactive test rate was extremely low (≤0.004).


Whole blood is now the preferred blood product for resuscitation of combat trauma patients.

The ASBP partnered with combat forces to screen personnel before deployment.

Additionally, LTOWB is manufactured and shipped in support of combat operations.

These efforts are expanding the availability of LTOWB for the warfighter.


Taylor, A.L., Corley, J.B., Swingholm, M.T., Sloan, M.A., McDonald, H. Jr., Quesada, J.F., Evans, C.L. & Ceballos, W.A. (2020) Lifeline for the front lines: blood products to support the warfighter. Transfusion. 59(S2), pp.1453-1458. doi: 10.1111/trf.15165.


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