Where does all the blood go?

Sept. 25, 2018
ASWBPL-West, Travis AFB, CA
From left to right: Lt Rafael Dy, SPC Michael Taylor, HM1 Alphonso Johnson, Rhonda Rooney, Joahna Lagman, SPC James Barnett, HM3 Devyn Aguilar, Michael Butac, SSgt Elisabeth Wilson, SSG Shameka Miller and TSgt LeVaughn Grant. Not shown: HM2 Jireh Cohen.

There is a hidden gem of assignments for medical laboratory technicians in the Department of Defense (DoD). Most military members, including laboratory technicians, don’t know what it is until they are somewhat involved—even when its acronym is completely spelled out for them. The Armed Services Whole Blood Processing Laboratory (ASWBPL) is that hidden gem; of which there are two: (1) ASWBPL-East and (2) ASWBPL-West. ASWBPL-East was founded in 1955, and strategically located at McGuire Airforce Base (AFB), NJ while ASWBPL-West was founded forty years later in 1995, and strategically located at Travis AFB, CA.

The main mission of ASWBPL

We know that ASWBPL is related to the clinical laboratory since it employs laboratory technicians. Also, it must have something to do with blood processing because it is a part of the title. Is it a donor center? No; this lab does not have a phlebotomy section. A transfusion service, perhaps? Negative; it is not aligned with any hospital, so there are no patients to transfuse. The main mission of ASWBPL is to act as a giant blood depot for military blood.

Have you ever donated blood and wondered where it went? Was your blood collected through a military donor center facility? Or was there a civilian blood drive on a military installation? While there are many blood collection facilities in the U.S., they can generally all be grouped into one of four national entities:

  1. American Red Cross
  2. America’s Blood Centers
  3. Blood Centers of America, and
  4. Armed Services Blood Program (ASBP).

Civilian donor centers will fall under one of the first three organizations while all military donor facilities serve under the ASBP. While any donation could potentially save the life of another human being, the ASBP is the sole provider of blood for military members continental and overseas. That means if civilian donor centers hold blood drives on a military installation, those units will not be used for military personnel, even though military members donated. Only blood collected by an ASBP facility will go directly toward military members.

The ASBP is a tri-service organization comprised of Air Force, Army, and Navy personnel and is the official blood collecting, manufacturing, and transfusion program for the U.S. Armed Forces. Each service has its own respective Service Blood Program Office (SBPO) under the ASBP:

  • Air Force Blood Program,
  • Army Blood Program, and
  • Navy Blood Program.

Each SBPO oversees its respective branch’s donor centers and transfusion services. Some of the blood that is collected at a military donor center will, in turn, be sent to a military treatment facility to be used in a transfusion service/blood bank.

Where does the rest of the blood go?

The ASWBPLs are also tri-service organizations and serve directly under the ASBP. As previously mentioned, while these facilities do not collect or transfuse blood, their primary mission is to serve as a depot. Donor centers from each service contribute a quota of blood products to each ASWBPL that in turn will be shipped worldwide, serving/supplying all five major combatant commands. For example, if blood was donated at ASBBC-San Antonio, the blood could potentially be saving a wounded service member in one of the military’s area of operations.

While the primary mission for both ASWBPLs is to ship quality blood products worldwide, East and West differ in some ways. Both facilities support the continental U.S. military treatment facilities, VA hospitals, U.S. Navy ships, and even the President of the U.S., as well as aid in disaster and humanitarian relief. However, ASWBPL-East has the bigger storage and distribution mission with the capability of storing thousands of liquid and frozen blood products. As for distribution, in 2017 alone, ASWBPL-East shipped tens of thousands of units of blood products in support of three major combatant commands. ASWBPL-West also has the capability of storing thousands of liquid and frozen blood products; however, in 2017, ASWBPL-West shipped significantly less blood products in support of two combatant commands.

ASWBPL-West is a little more unique as it is one of only three facilities in the entire DoD with the capability to glycerolize red blood cells. ASWBPL-West is even more unique in that it is the only facility capable of freezing AS-5 preserved blood. There are several benefits to freezing blood. The most obvious is that the life of a unit can extend from 35 or 42 days (depending on anticoagulant used) to up to 10 years. This is especially important for those donors with rare antibodies/blood types. The increase of shelf life is also beneficial to lessen the impact of seasonal shortages. From a military standpoint, reserving a large stockpile of blood in case of a terrorist attack or major natural disaster would prove to be critical as the turn-around time from thawing/deglycerolizing frozen products vs. staging blood drives, collecting/processing, and then shipping liquid units is significant.

ASWBPL-West contributes more to the DoD than just worldwide blood support by serving as the Air Force’s sole training facility for Expeditionary Blood Transshipment and Frozen Blood teams. Every year, approximately 75-110 personnel enter ASWBPL-West’s doors to receive the highest quality blood training prior to their deployment. Between the two training classes offered, members from four different unit type codes receive a thorough, hands-on training experience ranging from effectively serving as a blood depot (receiving, storing, and shipping blood products—much like an ASWBPL), to building pallets, constructing an Alaskan shelter, and safely deglycerolizing (or thawing) frozen blood products for patient use.

In conclusion

It is quite remarkable that this small team has such a huge impact for the entire DoD. Consisting of only 12 personnel, each ASWBPL is staffed by three sailors, three soldiers, three airmen, and three civilian contractors. From receiving, testing, and shipping the highest quality blood products across the globe to manipulating red blood cells, extending their life-saving qualities, and finally equipping Air Force personnel with the knowledge and capabilities of practicing our responsibilities—this team is a prime example of a tri-service consistently achieving its mission. One team! One fight!