Regional
Delivering lifesaving blood when roads can’t reach: Leveraging drones for Transfusion Resilience
Sangeeta Pahuja
Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
Sumit Aggarwal
Indian Council of Medical Research (ICMR), New Delhi, India
Access to safe and timely blood transfusion is critical for reducing mortality in emergency scenarios such as hemorrhagic shock, obstetric complications, major trauma, and elective surgeries. However, in large and diverse countries like India, routine access to blood and its components remains challenging, particularly in geographically remote areas or during natural disasters. This is compounded by infrastructural bottlenecks, cold chain maintenance challenges, and time-sensitive clinical demands. A recent implementation feasibility study led by Indian researchers sheds light on a potential solution by rigorously assessing the scientific validity of alternate delivery mechanisms under field conditions.
The study, anchored in the National Capital Region of India, evaluated the feasibility of transport, biochemical stability and transfusion readiness of four key blood components: whole blood, packed red blood cells (PRBCs), fresh frozen plasma (FFP), and platelets, when transported under strict quality protocols, via alternate methods, benchmarked against conventional road transport. While unmanned aerial systems ( drones) were employed for the transport leg, the primary focus remained the maintenance of transfusion-critical parameters and feasibility under variable environmental conditions.
Figure 1: Delivery of Blood and other components via drone
Using a prospective double-blind design, 60 blood and component bags were analyzed before and after transport (in temperature-controlled conditions), using validated testing protocols. Parameters such as temperature, hemoglobin, hematocrit, plasma hemoglobin, LDH, potassium,etc were evaluated for whole blood and packed red cells. Fresh frozen plasma bags were evaluated for temperature, fibrinogen and Factor VIII levels; whereas, platelet bags were evaluated for temperature, swirling, any visible clumping, platelet counts, pH. Sterility testing was performed to ensure safe transport conditions. The study was conducted during peak summer (ambient temperatures reaching ~40°C), thereby simulating one of the most challenging periods for maintaining the cold chain.
Figure 2: Implementation Framework practiced for Drone based blood bag delivery (click the image to enlarge)
The findings were reassuring: none of the bags exhibited hemolysis, clumping, or breach of storage conditions. There was no statistically significant difference between parameters by road transport and drone transport. At the receiving end, all the quality parameters evaluated were within the acceptable range, and mirrored similar trends as seen in conventional delivery For example, PRBCs transported under both conditions showed minimal deviation in hematocrit and LDH, while platelets retained pH and count integrity.
Beyond laboratory data, the study underscored the potential of alternate transport modalities in reducing delivery time significantly. Blood units that typically took 55 minutes via road could be delivered in under 10 minutes, which can make a life-saving difference in critical care scenarios.
Of note, the study was conducted within a structured implementation science framework (EPIS: Exploration, Preparation, Implementation, Sustainment), emphasizing operational feasibility and long-term sustainability. This adds significant value, as transfusion programs in low- and middle-income countries often face implementation gaps despite strong technical guidelines.
