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Whole blood transfusion among allied partnerships: unified and interoperable blood banking for optimised care
  1. Scott Hughey1,2,
  2. J Kotler2,3,4,
  3. J Cole2,5,
  4. F Jewett6,
  5. K Checchi2,7 and
  6. A Lin4,8
  1. 1Anesthesiology and Pain Medicine, US Naval Hospital Okinawa, Okinawa, AP, Japan
  2. 2Naval Biotechnology Group, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
  3. 3Department of Orthopedic Surgery, US Naval Hospital Okinawa, Okinawa, Japan
  4. 43d Medical Battalion, III Marine Expeditionary Force, Okinawa, Japan
  5. 5Michaud Role 2 Expeditionary Medical Facility, Camp Lemonniere, Djibouti, Djibouti
  6. 6Department of Pathology, US Naval Hospital Okinawa, Okinawa, AP, Japan
  7. 7Department of Surgery, US Naval Hospital Okinawa, Okinawa, Japan
  8. 8Department of Cardiology, US Naval Hospital Okinawa, Okinawa, Japan
  1. Correspondence to Dr Scott Hughey, Anesthesiology and Pain Medicine, US Naval Hospital Okinawa, Okinawa, AP, Japan;{at}


Whole blood transfusion is being increasingly used for trauma resuscitation, particularly in military settings. Low-titre group O whole blood simplifies the logistical challenges and maximises the benefits of blood transfusion when compared with component therapy in austere battlefield conditions. Screening protocols and blood testing requirements for prescreened donors in walking blood banks (WBBs), which are used for emergency transfusions, are established by both the USA and most partner nations, though they are not necessarily uniform across these combined forces. Interoperability and standardisation of blood bank resources and protocols across allied forces in multinational military operations, including uniformity in screening processes, collection methods and storage is essential to the provision of safe and effective blood product transfusions in this austere setting. Predeployment screening, multinational training exercises and universal WBB sets with instructions in multiple languages can help enhance the interoperability of combined multinational operations and create a more efficient WBB system. Standardisation of blood collection, nomenclature, equipment and screening practices will allow for the most optimal utilisation of whole blood resources across a multinational battlefield.

  • Blood bank & transfusion medicine
  • Trauma management

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  • Contributors All authors (SH, JK, JC, FJ, KC and AL) contributed equally to the ideation, background, analysis, manuscript preparation and final manuscript approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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