By Carl Norman, Fort Leonard Wood Blood Donor Center

FORT LEONARD WOOD, Mo. (July 12, 2023) — When America’s military members are injured on the battlefield, medics walk a line between life and death trying to get them help. They have many resources in their medical kits, and one of the newer ones is low-titer O whole blood.

The collection of low-titer O whole blood, or LTOWB, is an Armed Services Blood Program initiative that focuses on blood from donors who have had an antibody titer test showing they have low levels of anti-A and anti-B antibodies. High levels of these antibodies can cause transfusion reactions in patients with other blood types, according to Col. Christopher Evans, Army Blood Program director.

“LTOWB can be transfused into patients of any blood type, making it a valuable tool for the military which often needs to transfuse blood in austere environments where blood typing is not always possible,” he said. “It’s been shown to be safe and effective in military settings, especially during combat operations. In a study of soldiers who received it during combat operations in Iraq and Afghanistan, the risk of transfusion reactions was significantly lower than those in Soldiers, who received blood from traditional blood banks.”

LTOWB contains red-blood cells, plasma and platelets from a single donor, Evans said. It is often used for transfusions in emergency situations, or for patients requiring massive transfusions.

“Donors with type-O blood are the most common source of LTOWB because they are universal donors, meaning that their blood can be transfused to patients with any blood type without causing an adverse immune response,” he added.

With LTOWB containing both red blood cells and plasma, Evans said it may have advantages over transfusions with red-blood cells alone in certain situations, such as in patients with massive hemorrhaging or traumatic injuries.

The Blood Donor Center here is one of seven Army blood donor centers that collect LTOWB for the ASBP. It is a strategically important asset, according to Evans.

The facility is a central location, making it an ideal hub for blood collection and distribution for both the Midwest region and worldwide combat operations. Collecting blood from donors throughout the region, the center distributes to military hospitals and clinics across the Midwest.

“The center also plays a vital role in the LTOWB program,” he said. “This is a valuable tool for the military, and Fort Leonard Wood’s donor pool makes them an important part of the Army’s blood supply chain to support the military’s blood mission.”

According to Capt. Marianne Rose, Fort Leonard Wood Blood Donor Center director, using whole-blood products is an older concept that was abandoned due to its risk of causing severe transfusion reactions and using individual components – red cells and plasma separately – has been the product of choice since World War II.

“However, with a better understanding of blood over time, and through trial and error, whole blood has resurfaced, but with some exceptions, such as low titer, which is now being used to treat massive transfusion traumas – it’s proving to be better than component therapy in certain circumstances,” Rose said.

The LTOWB program is only one part of the mission the Fort Leonard Wood Blood Donor Center supports. The center also provides many other products, including packed red-blood cells and fresh, frozen plasma that help people around the world recover from injury and illness. The center here is also now partnering with the Department of Defense bone-marrow donor program, Salute to Life, Rose said.

“But we can’t do what we do without donors who are willing to give,” she said. “We’re asking everyone on Fort Leonard Wood to celebrate their health by giving blood, so we can continue making low-titer O whole blood and all blood products available to those protecting our freedom at home and abroad.”

The Fort Leonard Wood Blood Donor Center accepts appointments and walk-in donors from 8 a.m. to 4 p.m. Monday through Wednesday. Call 573.596.6150 to make an appointment or for more information about the ASBP mission and donor eligibility.

Low-titer O whole blood has low levels of anti-A and anti-B antibodies, high levels of which can cause transfusion reactions in patients with other blood types. The Fort Leonard Wood Blood Donor Center collects this blood to support the Army Blood Service Program. (Photo by Carl Norman, Fort Leonard Wood Blood Donor Center)














About Fort Leonard Wood

Fort Leonard Wood is a thriving and prosperous installation that has evolved from a small basic training post 80 years ago to a premier Army Center of Excellence that trains nearly 80,000 military and civilians each year.

Fort Leonard Wood is home to the U.S Army Maneuver Support Center of Excellence and three U.S. Army schools: the U.S. Army Engineer School; U.S. Army Chemical, Biological, Radiological and Nuclear School; and the U.S. Army Military Police School. In addition to training engineer, CBRN and military police specialties for the Army, Fort Leonard Wood also provides gender-integrated in-processing and Basic Combat Training for new Soldiers.

Fort Leonard Wood also hosts and trains with the largest Marine Corps Detachment and Air Force Squadron on any Army installation as well as a large Navy construction detachment.

More information about Fort Leonard Wood is at: