Obstacles to an Effective Low-Titer O Walking Blood Bank: A Deployed Unit's Experience

We present the experience of our U.S. Navy Role 2's deployment to the U.S. Central Command area of responsibility in support of Operation Inherent Resolve and serving a multinational, joint-service military base. We detail our efforts to establish a low-titer O (LTO) walking blood bank (WBB) in an effort to prepare for potential combat casualties.

We decided on an LTO WBB based on our available resources and a review of the literature. We collected blood samples from volunteer O-type donors throughout deployment. We conducted some titers locally and sent all samples to the ASBP in San Antonio for confirmatory testing. We conducted internal training on the WBB to improve our efficiency. We conducted monthly base-wide drills and blood drives to increase our donor pool and improve coordination between the multiple units on base.

We were able to collect samples from 108 military members during our deployment. Because of cold chain and shipping issues, by the time we departed theater, we had confirmation of 31 LTO donors from the Armed Services Blood Program. Thanks to local titers and units arriving to theater with titers complete; we were able to maintain an LTO donor pool close to our intended target of 50 available donors through most of our deployment.

A WBB based on LTO blood is possible in theater. In order to maximize donor pools, it is imperative that units deploying to forward areas complete titer and transfusion transmissible disease testing before arrival in theater.