Brothers in Arms

Brothers in Arms is an initiative by South Texas Blood & Tissue Center to help establish a stable, easily replenished blood product that can be used in emergency situations. San Antonio is one of the first cities to implement the program. 

The program is based on research done by the U.S. Army and the Mayo Clinic. The studies found that type O donations from men with lower levels of certain types of antibodies can be used for whole blood transfusions in patients of any blood type.

The program represents a collaboration involving:


What is the blood product? 

It is type O-positive whole blood that has low levels of certain antibodies, making it usable in patients of any blood type in emergencies. This stored whole blood is stable up to 35 days and includes all blood components, which has been shown to lead to better outcomes for trauma patients than transfusions of individual blood components. 

Why is the initiative so critical for medical traumas? 

This initiative has transformed the way trauma care is delivered at trauma scenes, onboard medical helicopters and at emergencies involving San Antonio Fire Department Command Units. 

The normal mortality rate when a trauma patient arrives at the hospital requiring massive transfusions (10 units or more in a day) is 75 percent. 

Research done by the military focused on providing whole blood transfusions earlier, since whole blood is better for replacing what the patient loses through massive bleeding. 

The military showed that adding whole blood to early transfusion protocols decreased the mortality rate from 60 percent (when patients received mainly red blood cells) to 20 percent for patients receiving whole blood, demonstrating a dramatic improvement in survival rates. The patients receiving whole blood also required fewer transfusions to keep them stabilized. 

How are members of the Brothers in Arms identified? 

Type O-positive blood donations by men who donate at an STBTC donor room will be tested for specific antibody levels. Those below a certain threshold will be identified as potential donors for the program. 

Why only men? 

Men tend to have lower levels of antibodies in their blood than women, which helps prevent reactions in patients who receive a transfusion. Blood from men in the Brothers in Arms initiative can be received by almost any patient, which is critical in emergency situations when there is no time to test a patient’s blood type.

Where will this blood be used? 

Brothers in Arms whole blood is being carried on 18 medical helicopters serving South Texas, as well as on San Antonio Fire Department Command Units and Local Level 1 trauma centers. 

What are the advantages of this program? 

Using stored whole blood for trauma victims has been shown to be more effective in the treatment of traumatic injuries since it contains all the major blood components: red blood cells, which are lost in bleeding; platelets, which help seal breaks in blood vessels; and plasma, which boosts blood volume. 

Stored whole blood is especially significant for trauma treatments because under current guidelines, platelets by themselves are usable for only three to five days. When refrigerated, whole blood can be stored up to 35 days. 

This program has also expand the pool of products available for emergency use, since O-positive is the single largest blood type in the United States. It will help alleviate chronic shortages of O-negative blood, which has been used for emergency transfusions for many years but is found in just 7 percent of the population. 

Is this a new idea? 

No, but we are one of the first communities in the country to implement it. A similar program was used during the latter stages of World War II, the Korean War and the Vietnam War for battlefield transfusions. The concept was revived by studies conducted by the Mayo Clinic and the U.S. Army. 

Will this change the donation process? 

No. Whole blood donation will be exactly the same as it is now. Brothers in Arms donors may be asked to give two to three times a year. 

Are there other eligibility requirements? 

Just one: Donors cannot be on an aspirin regimen, since that affects the functioning of platelets in the donated blood. 

How is BioBridge Global involved?

The blood collection will be done by STBTC and testing for antibody levels will be conducted by QualTex Laboratories, which worked with the Army to shorten testing times. 

Male donors who would like to see if they qualify to be a Brothers in Arms volunteer are encouraged to call 210-731-5590 to schedule an appointment for testing or email us by clicking the button below.