Evaluation of Pathogen-Reduced Whole Blood for Field Transfusion in Trauma Care

Bystrik Adamek; X. Ruttkay; T. Chudik

doi:10.5281/zenodo.22818827

Authors

Bystrik Adamek Department of Coagulation Medicine, Weser Center for Stem Cell and Marrow Sciences Author https://orcid.org/4739-3397-6166-8356
X. Ruttkay Department of Laboratory Hematology, Meuse Center for Transfusion Sciences Author https://orcid.org/8221-9990-2824-6579
T. Chudik Department of Coagulation Medicine, Struga Center for Hemoglobinopathy Research Author https://orcid.org/5254-2713-1104-6102

DOI:

https://doi.org/10.5281/zenodo.22818827

Keywords:

whole blood, pathogen reduction, trauma resuscitation, hemostasis, prehospital transfusion

Abstract

Graphical abstract

Background: Low-titer group O whole blood (LTOWB) has displaced component therapy at the point of injury in military and civilian trauma systems, but its unscreened, minimally processed nature carries transfusion-transmitted infection risk that pathogen reduction technology is proposed to resolve.

Objective: To synthesize the published evidence on whether pathogen-reduced whole blood, using amustaline/glutathione or riboflavin/UV platforms, preserves the hemostatic performance that makes whole blood valuable for field trauma resuscitation.

Methods: Narrative synthesis of clinical, animal and in vitro literature on LTOWB outcomes in trauma resuscitation and on pathogen reduction chemistries applied to whole blood and whole blood-derived red cells.

Findings: LTOWB has an increasingly solid observational and early-trial basis over component therapy, and both pathogen reduction platforms preserve red cell recovery within regulatory bounds through storage, but both measurably reduce platelet aggregation and fibrinogen-dependent clot strength relative to untreated product.

Conclusions: A trauma-specific, bleeding-outcome-powered trial of pathogen-reduced whole blood is needed before it can be recommended as a direct field substitute for conventional LTOWB.

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