The reason to expand to NBB-TSWB in the DoD’s trauma system is multifactorial. NBB-TSWB has been used historically in the U.S. until the 1980s and is still used in certain countries that never adopted widespread component manufacture from whole blood. Using NBB-TSWB expands the donor pool and helps alleviate supply constraints associated with NBB-LTOWB.30 However, as mentioned above, adopting NBB-TSWB requires careful recipient blood typing to ensure ABO compatibility and prevent acute hemolytic transfusion reactions.

Given the potential challenges of supply combined with the high demand of LTOWB there is risk of shortage of LTOWB to meet the demands of the future operating environment. Augmenting the blood supply with NBB-TSWB, particularly Type A Whole Blood, will mitigate the risk of running out of LTOWB. By having ASBP supplied whole blood (NBB-TSWB) for both Group O and Group A, the majority of the U.S. population’s blood types will be covered given that 40% is Type A and 45% are Type O.