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Updated: Sep 9, 2025

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Low-titer O whole blood (LTOWB) offers balanced transfusion for major bleeding. Implementing LTOWB in Swedish healthcare involves logistical strategies to minimize wastage, balancing prehospital needs with hospital use and red blood cell preparation.

Keywords:
blood center operationsblood component preparationsblood management

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Area of Science:

  • Transfusion Medicine
  • Emergency Medicine
  • Logistics and Supply Chain Management

Background:

  • Low-titer O whole blood (LTOWB) is increasingly used in civilian prehospital care for major bleeding.
  • LTOWB provides a balanced transfusion of red blood cells, coagulation factors, and platelets.
  • Challenges include LTOWB availability and predicting demand, risking wastage.

Purpose of the Study:

  • To describe logistical strategies for implementing LTOWB in Swedish civilian healthcare.
  • To analyze experiences from five transfusion centers regarding production, usage, and wastage.
  • To identify effective methods for reducing LTOWB wastage.

Main Methods:

  • A descriptive study involving five Swedish transfusion centers producing LTOWB.
  • Data collection on production lines, usage patterns, and wastage rates.
  • Analysis of implemented logistical strategies to mitigate wastage.

Main Results:

  • LTOWB is utilized prehospital (HEMS, rapid response vehicles) and inhospital (University Hospitals).
  • Logistical strategies include rotating unused prehospital LTOWB for inhospital use and preparing RBC units from older LTOWB.
  • Wastage rates ranged from 0%-13% in four centers, with one center reporting 34% wastage.

Conclusions:

  • Predicting the need for LTOWB in prehospital emergencies is challenging.
  • Minimizing wastage requires tailored logistical chains based on local conditions.
  • Swedish centers employ LTOWB rotation or RBC preparation to manage supply and demand.