Also Moving From Iraq to Afghanistan: Blood Platelets

President Obama will meet with the Joint Chiefs of Staff Friday to debate the wisdom of sending up to 40,000 more U.S. troops to Afghanistan. The meeting comes as the deadliest month for U.S. troops in eight years of war draws to a close — a spike in casualties that has already triggered a flow of precious reinforcements. The U.S. military has begun for the first time transferring from Iraq to Afghanistan pint-sized bags of platelets — the key blood component that encourages clotting and can prevent wounded soldiers from bleeding to death.

U.S. forces in Iraq needed the life-saving elixir far more than those in Afghanistan until fairly recently. Back in October 2006, 106 U.S. troops died there compared with 10 in Afghanistan. Three years later, those numbers have flipped: 56 U.S. troops have been killed in Afghanistan so far this month, compared with six in Iraq. On Thursday, President Obama called his visit to Delaware's Dover Air Force Base in the wee hours to witness the return of 18 U.S. troops killed in the Afghan war "a sobering reminder of the extraordinary sacrifices that our young men and women in uniform are engaging in every single day."

But despite the grim tableau witnessed by Obama, it could have been worse. A 2008 Army book on combat surgery in Iraq and Afghanistan says the "recent (limited) theater availability of ... platelets" is a key reason for a significant reduction in fatal bleeding. Wounds that cause such hemorrhages are "the most preventable cause of death on the battlefield," it says, adding that pumping platelets into a wounded soldier is better than using whole blood.

Platelets — the "body's own Band-Aid" — circulate along the smooth walls of blood vessels, seeking telltale signs of a leak. Once detected, the colorless, irregularly-shaped platelets stick to the rupture's edge and attract fellow platelets to join it in a clump and begin the process of sealing the wound. "We noticed an increase in the survival rate compared to when we were using whole blood," Air Force Lieutenant Colonel Thomas Jordan, who oversees platelet collection in Balad, Iraq, told a military interviewer in August. "They serve as the main factor in stopping bleeding and are used in any situation in which there is excessive blood loss."

Beginning in 2006, U.S. troops have been donating about 60 bags a week of platelets at the Air Force Theater Hospital in Balad, sitting back and watching a movie as an IV siphons the donor's blood through a centrifuge, where the platelets are separated out before the blood is returned to the donor. Soldiers can volunteer for the two-hour procedure twice a month. But platelets' life-saving properties don't last long — there is no way to preserve them, and the cloudy, yellow liquid containing them typically has to be discarded a week after it is drawn. Their short shelf-life outside the body means that the platelets have to be drawn close to the front lines.

As the Iraq war has wound down, a growing share of the platelet supply was going to waste, and on Oct. 14 the first batch was sent the more than 1,000 miles from Balad to a U.S. military hospital in Kandahar, Afghanistan. Pentagon officials say it makes more sense to tap into the existing setup in Iraq for platelets than to try to establish a similar pipeline in Afghanistan.
Time