Thank you Ward_X, SMiller and Dr. Blumberg for your time and reply.
I Agree with the above: There is so much extrapolation and assumptions involved in the decision to use Low titer O group in Hospital settings. Like for e.g. the proponents are showing military data as evidence, but the military uses WARM Fresh whole blood. Secondly, data is about penetrative trauma and whole blood is giving at site or within the golden hour. Urban hospital settings are so much different. Third, the proponents claim success of programs at Utah, Pittsburg, Mayo etc. However, so many questions (see below) are unexplored or unanswered.
I agree with SMILLER about practicality of use. If one were to set up Low titer whole blood:
1). In which scenarios or patients would you use? (trauma or other massive bleed?, penetrative trauma vs blunt trauma, is there a time limit within which it has the best beneficial effect? What sex and age group to use for?
2) What titer is acceptable? IgM and IgG, whether the titers are done in viv from Patients draw or from the unit, whether the titer is historical or done every time the donor donates?
3) what anticoagulant is used for storage....whether titers should be different for different volumes of anticoagulant (dilutional effects?)
5). Is old whole blood (>14 days) as beneficial as fresh cold whole blood (1-14 days) or as WARM whole blood?
Too many questions
But the most significant if wish to explore is, How to set up hospital criteria to issue whole blood?
Thanks again for you insights and time.