A Model for Use of Low-Titer “O” Whole Blood in a Community Level III Trauma Center: Cost Effectiveness, Utilization, and Prevention of Precious Resource Wastage

Low-titer "O" negative whole blood (LTOWB) is efficacious in hemorrhage, but adoption of this resource has lagged other advances in our Arkansas Trauma System. Of the 57 trauma centers (TCs) in our system, only 2 use LTOWB. Reasons for TCs not using LTOWB are concerns of cost and wastage acting as barriers for adoption. Our Level III TC was the first in our state to use LTOWB and developed pathways to promote efficient usage and avoid wastage. From 2022 to 2024, our TC transfused 2859 units of RBCs to 1372 patients, with 124 patients receiving 190 units of LTOWB. Our blood bank achieved zero wastage of our supply of LTOWB, with 93% of LTOWB being used without conversion and 7% being converted to RBCs. We hope our methodology to conserve LTOWB by protocols without incurring additional costs to supply LTOWB versus standard balanced transfusion will serve as impetus for expanded usage.