Article Text

Download PDFPDF
Group O low titre only emergency donor panels for small combat teams
  1. Heidi Doughty1,2,
  2. A Maguire3,
  3. G Fitchett3 and
  4. P Parker3,4
  1. 1 NHS Blood and Transplant, Birmingham, UK
  2. 2 Academic Department of Military Anaesthesia and Critical Care, Birmingham, UK
  3. 3 The Royal Centre for Defence Medicine, Queen Elizabeth Hospital, Birmingham, UK
  4. 4 Senior Lecturer in SOF Medicine, University College Cork, Cork, Republic of Ireland
  1. Correspondence to Heidi Doughty, Department of Medical, NHS Blood and Transplant, Birmingham, West Midlands B15 2SG, UK; heidi.doughty{at}


Introduction Military elements increasingly operate in small teams in remote areas with no immediate blood product support. Planners and operators may endorse collection of fresh whole blood from pretested donors in emergency situations. The biggest risk of transfusion is the accidental use of ABO incompatible blood which can be fatal. The risk may be mitigated by using only group O LOw (OLO) titre donors with plasma containing low levels of the naturally occurring antibody to group A and B red cells. This paper reviews the ABO blood group distribution in potential blood donors from a high readiness UK medical regiment and explores the feasibility of using only group OLO donors in small teams.

Methods A retrospective review of routine volunteer blood donor samples was undertaken at 6 monthly intervals during a 2-year period. Personnel were tested in groups when available during training to create multiple donor panels to simulate small teams.

Results 206 donation samples were collected from 157 potential donors. All donors were acceptable based on the lifestyle questionnaire, serology and microbiology screen. Of the 206 samples reviewed, 85 (41%) were group O (D pos and D neg). 14 group O (16.5%) were shown to have high titre of anti-A or B. Therefore, 71, that is, 34% overall were suitable as OLO donors. The donor panel size varied from 15 to 44. The absolute number of OLO donors in each panel ranged from 4 to 17 and the number of O neg donors was 0–3.

Conclusion A third of samples were suitable as OLO donors; however, there were insufficient ‘universal’ donors within smaller subgroups (<10). In this situation, we recommend the careful use of both group O and group A donors or the use of a buddy-buddy blood group matrix.

  • military medicine
  • emergency donor panels

Statistics from


  • Contributors HD conceived the audit and was the primary author of the paper. GF and AM collated the data and provided technical details. PP contributed to paper writing and discussion and acts as sponsor.

  • Competing interests None declared.

  • Patient consent None.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Correction notice This article has been corrected since it first published Online First. Figure 1 has been removed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.