About the massive transfusion protocol

Rationale. On September 1, 2025, new Rules for the Procurement, Storage, Transportation and Clinical Use of Donor Blood and its Components came into force in Russia, legalizing three new clinical concepts: massive transfusion, massive blood loss and massive transfusion protocol (MTP). The following questions need to be answered: 1) What is massive blood loss? 2) How long does a massive transfusion last? 3) How does a MTP differ from a guide to providing medical care? Objective: to search for the definitions of “massive blood loss” and “massive transfusion protocol”, to assess the compliance of the MTP rules with blood transfusion standards and the achievements of evidence-based medicine in the field of transfusiology. Methods. A search of reviews, meta-analyses and randomized clinical trials was conducted using the words “massive blood loss”, “massive transfusion protocol” in Russian and English in the electronic libraries of Russia (eLibrary.ru) and the USA (pubmed.ncbi.nlm.nih.gov). Results. The term “massive blood loss” is incorrect without a time frame. MTP is best represented as 7 components: 1) start, 2) command, 3) tranexamic acid, 4) testing, 5) blood transfusion, 6) temperature and 7) termination. Conclusion. As in any emergency and complex situation requiring a rapid response, the readiness of both blood providers and recipients with their standard operating procedures and MTP ensures an effective response and increases the chances of saving patients.