Low titer group o whole blood (LTOWB)
LTOWB is derived from a donor of o group, and it has low levels of titres of anti a and anti b (IgM <250.4). It has been used widely for resuscitating hemorrhagic shock secondary to massive trauma. Shelf life is 21 days with citrate phosphate dextrose (CPD) and 35days with citrate phosphate dextrose adenine (CPDA-1)
Advantages of LTOWB
More concentrated product than component therapy
Increased oxygen carrying capacity (more Hb concentration
More coagulation factors and platelet concentration
Less acidotic
Less error
Use of LTOWB in ED
Prehospital low titer group o whole blood vs standard transfusion in injured air medical patients (Guyyette et al). There were no significant differences in rate of early mortality. The incidence of multiorgan dysfunction and nosocomial infections were less in LTOWB group (not statistically significant). Also, LTOWB group had less red cell component transfusion.
LTOWB transfusion vs component therapy in severe traumatic hemorrhage (shea et al. LTOWB group had less blood products than component therapy group (statistically significant).
LTOWB transfusion in non-traumatic hemorrhagic shock (christian et al)- length of stay in hospital was less in LTOWB group was less compared to component therapy group (statistically significant). There is statistically significant difference in mortality rate in both groups.
