Appropriate transport of whole blood by drones for cases of massive bleeding

Background: Whole blood (WB) can be superior to red blood cell (RBC) solutions for transfusion in hemorrhage because it contains coagulation factors and platelets. A previous study reported that the quality of an RBC solution and WB can be maintained during transport by an uncrewed aerial vehicle (drone) at normal temperature. Therefore, we aimed to determine whether this approach could also be used for transport of WB for cases of massive bleeding on the hot and cold days that occur in Japan, by testing this approach twice, on hot and cold days. Method: We used an automobile-transported WB packs obtained by phlebotomy and corresponding segments to a test place in Tomi at a distance of approximately 200 km from Tokyo. Subsequently, a drone (M1000) flight transported the WB and its segments. Results: The influence of the drone flight on WB appeared to be minimal on lactate dehydrogenase (LDH) level, and the WB was confirmed to be problem-free in coagulation tests. Conclusion: We transported WB by the drone and confirmed that there were little hemolysis of the WBs and little reduction in the levels of coagulants.