{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T02:53:10Z","timestamp":1790909590556,"version":"4.1.0"},"reference-count":12,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Low\u2010titer O whole blood (LTOWB) is found to be associated with a survival advantage in trauma\u2010related major hemorrhage in some prospective studies. The role of LTOWB in non\u2010trauma patients has not been as extensively studied. In this study, we assess the feasibility and safety of administering LTOWB to patients with life\u2010threatening gastrointestinal bleeding (GIB) and post\u2010partum hemorrhage (PPH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>We performed a retrospective study of patients who received LTOWB at a large regional academic center for life\u2010threatening GIB and PPH according to hospital protocol between 1 December 2023 and 31 December 2025. Demographic, clinical, transfusion, laboratory data, including hemolysis\u2010related variables, and clinical outcomes were compared between group\u2010O and non\u2010group\u2010O patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We studied 112 patients, 53 men and 59 women, with a median (interquartile range [IQR]) age of 68 (41\u201377) years. Of these, 87\/112 (77%) had GIB and 25\/112 (23%) had PPH; 38\/112 (34%) were group\u2010O and 74\/112 (66%) non\u2010group\u2010O. In total, 203 LTOWB units were transfused, 155 for GIB and 48 for PPH. The median (IQR) number of LTOWB units transfused to both group\u2010O patients and non\u2010group\u2010O was 2 (1\u20132). There were no clinically significant laboratory or mortality differences between group\u2010O versus non\u2010group\u2010O patients, which was 3% versus 4% at 24\u2009h, respectively. No hemolytic transfusion reactions were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LTOWB transfusion for life\u2010threatening GIB or PPH is feasible and not associated with hemolysis in non\u2010group\u2010O recipients. Further studies are required to determine the clinical utility of this transfusion strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/vox.70381","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T02:04:50Z","timestamp":1790906690000},"source":"Crossref","is-referenced-by-count":0,"title":["Low\u2010titer\n                    <scp>O<\/scp>\n                    whole\u2010blood transfusion for life\u2010threatening gastrointestinal and post\u2010partum hemorrhage"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3140-6382","authenticated-orcid":false,"given":"Alex","family":"Osnis","sequence":"first","affiliation":[{"name":"Blood Bank Meir Medical Center  Kfar Saba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5043-8690","authenticated-orcid":false,"given":"Vered","family":"Yahalom","sequence":"additional","affiliation":[{"name":"Blood Services and Apheresis Institute Rabin Medical Center  Petach Tikva Israel"},{"name":"Gray Faculty of Medicine and Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1721-0541","authenticated-orcid":false,"given":"Philip C.","family":"Spinella","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5658-248X","authenticated-orcid":false,"given":"Eilat","family":"Shinar","sequence":"additional","affiliation":[{"name":"National Blood Services Magen David Adom  Ramle Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Izak","sequence":"additional","affiliation":[{"name":"National Blood Services Magen David Adom  Ramle Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Shamiea","sequence":"additional","affiliation":[{"name":"Department of Medicine A Meir Medical Center  Kfar Saba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merav","family":"Barzilai","sequence":"additional","affiliation":[{"name":"Blood Services and Apheresis Institute Rabin Medical Center  Petach Tikva Israel"},{"name":"Gray Faculty of Medicine and Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1941-1550","authenticated-orcid":false,"given":"Jacob","family":"Chen","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medicine and Health Sciences Tel Aviv University  Tel Aviv Israel"},{"name":"Department of Hospital Administration Meir Medical Center  Kfar Saba Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6740-2758","authenticated-orcid":false,"given":"Mark","family":"Yazer","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medicine and Health Sciences Tel Aviv University  Tel Aviv Israel"},{"name":"Department of Pathology University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6804-1472","authenticated-orcid":false,"given":"Martin","family":"Ellis","sequence":"additional","affiliation":[{"name":"Blood Bank Meir Medical Center  Kfar Saba Israel"},{"name":"Gray Faculty of Medicine and Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"e390","DOI":"10.1097\/CCM.0000000000006244","article-title":"The efficacy of low\u2010titer group O whole blood compared with component therapy in civilian trauma patients: a meta\u2010analysis","volume":"52","author":"Morgan KM","year":"2024","journal-title":"Crit Care Med"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"S112","DOI":"10.1111\/trf.17331","article-title":"Risk factors for massive transfusion in obstetrical hemorrhage and consideration of a whole blood program","volume":"63","author":"Myers JC","year":"2023","journal-title":"Transfusion"},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"6455","DOI":"10.1080\/14767058.2021.1915275","article-title":"Whole blood transfusion reduces overall component transfusion in cases of placenta accreta spectrum: a pilot program","volume":"35","author":"Munoz JL","year":"2022","journal-title":"J Matern Fetal Neonatal Med"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1111\/trf.70013","article-title":"Whole blood transfusion in the management of obstetric hemorrhage: a scoping review","volume":"66","author":"Lalonde J","year":"2026","journal-title":"Transfusion"},{"key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"3089","DOI":"10.1111\/trf.15492","article-title":"First report of using low\u2010titer cold\u2010stored type O whole blood in massive postpartum hemorrhage","volume":"59","author":"Bahr TM","year":"2019","journal-title":"Transfusion"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1080\/10903127.2019.1671562","article-title":"Prehospital transfusion of low\u2010titer O+ whole blood for severe maternal hemorrhage: a case report","volume":"24","author":"Newberry R","year":"2020","journal-title":"Prehosp Emerg Care"},{"key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.1111\/trf.15731","article-title":"Whole blood for postpartum hemorrhage: early experience at two institutions","volume":"60","author":"Morris DS","year":"2020","journal-title":"Transfusion"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1097\/AOG.0000000000005320","article-title":"Whole blood administration for obstetric\u2010related hemorrhage during prehospital transport","volume":"142","author":"Polzin A","year":"2023","journal-title":"Obstet Gynecol"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"e129","DOI":"10.1055\/s-0044-1786712","article-title":"Low\u2010titer type O whole blood for transfusing perinatal patients after acute hemorrhage: a case series","volume":"14","author":"Carr NR","year":"2024","journal-title":"AJP Rep"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"4934","DOI":"10.1177\/00031348211048831","article-title":"Efficacy and safety of whole blood transfusion in non\u2010trauma patients","volume":"89","author":"Smith AA","year":"2023","journal-title":"Am Surg"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"S173","DOI":"10.1111\/trf.18203","article-title":"Expanding beyond trauma: characterizing low titer group O whole blood (LTOWB) use in children requiring massive transfusion protocol activation","volume":"65","author":"Feeney EV","year":"2025","journal-title":"Transfusion"},{"key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1111\/vox.13232","article-title":"Incidence of anti\u2010D alloimmunization in D\u2010negative individuals receiving D\u2010positive red blood cell transfusion: a systematic review and meta\u2010analysis","volume":"117","author":"Ji Y","year":"2022","journal-title":"Vox Sang"}],"container-title":["Vox Sanguinis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/vox.70381","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/vox.70381","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/vox.70381","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T02:04:58Z","timestamp":1790906698000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/vox.70381"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,1]]},"references-count":12,"alternative-id":["10.1111\/vox.70381"],"URL":"https:\/\/doi.org\/10.1111\/vox.70381","archive":["Portico"],"relation":{},"ISSN":["0042-9007","1423-0410"],"issn-type":[{"value":"0042-9007","type":"print"},{"value":"1423-0410","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,1]]},"article-number":"vox.70381"}}