Utilization and safety outcomes following the use of low titer group O whole blood in non‐trauma patients

BACKGROUND: Low Titer Group O Whole Blood (LTOWB) use has expanded to include patients with non-traumatic bleeding etiologies. While a large body of evidence supports a potential survival benefit of LTOWB in trauma patients, data demonstrating the safety and efficacy of LTOWB in non-trauma patients are lacking. STUDY DESIGN AND METHODS: Non-trauma adult patients at two hospitals who received at least one unit of LTOWB were included in the study. Patient demographics, transfusion and laboratory data, diagnoses, mortality, and hospital length of stay were collected between January 1, 2018, and June 30, 2024. LTOWB recipients were further stratified by O versus non-group O blood group, and laboratory markers of renal failure and hemolysis were compared between these two groups. RESULTS: A total of 319 unique patients with 320 LTOWB transfusion episodes were included. The most common indications for transfusion were gastrointestinal and cardiovascular bleeding (266/320, 83%). In-hospital survival at 24 h and 30 days posttransfusion was 75% and 53%, respectively. There was no statistically significant difference in markers of hemolysis between group O and non-group O LTOWB recipients. There were no reported transfusion reactions. DISCUSSION: In non-trauma settings, LTOWB was most commonly utilized in patients with gastrointestinal and cardiovascular bleeding. LTOWB is a safe alternative to component therapy in non-trauma adult populations. However, additional studies are needed to focus on efficacy and clinical outcomes in non-trauma patients that receive LTOWB for severe hemorrhage.