In February 2007, a large twin-rotor medical evacuation helicopter had just delivered three injured US soldiers to a field hospital in Balad, north of Baghdad. Almost immediately, it was tasked with another urgent flight—this time across insurgent-held territory in full daylight. For aircraft that typically moved under cover of darkness with lights out, the mission was unusually exposed.
Near the city of Karmah in eastern Al-Anbar province, an insurgent fired a shoulder-launched missile. The helicopter’s tail gunner, likely seeing the launch, shouted for evasive action. But the weapon had already acquired its target. The hit triggered an onboard fire, and despite the pilot’s efforts to keep the aircraft aloft for 58 seconds, the helicopter—call sign Morphine 1-2—crashed. All seven crew members died.
The reason the aircraft was taking such a risk highlights a problem that extends far beyond war zones. “It was getting blood and bringing it back,” says Lieutenant Commander Robert Murray, a US Navy officer and program manager at the Defense Advanced Research Projects Agency (DARPA), who reviewed the incident while working in military intelligence. The flight was a “blood run,” he explains—treated as a top operational priority, second only to evacuating casualties.
Today, a persistent scarcity of donated blood in both military and civilian systems is accelerating efforts to develop substitutes. Hemorrhage—severe bleeding after a blood vessel is damaged—accounts for about 90% of preventable deaths on the battlefield. It is also the leading cause of maternal mortality worldwide. In the US, the gap between need and supply is stark even before patients reach a hospital: a 2025 study in Transfusion reported that among 1.2 million trauma patients who might have benefited from transfusion prior to arrival, only 1% actually received blood. The American College of Surgeons estimates the shortage contributes to roughly 10,000 preventable deaths each year in the US; globally, the toll is likely far higher—potentially in the millions.
A key driver of the shortage is that blood is difficult to store and distribute. Refrigerated whole blood remains usable for only 35 days, prompting blood banks to separate donations into components to extend practical shelf life. But each component brings its own constraints. Platelets, essential for clot formation, are commonly stored at room temperature and typically remain viable for a week or less. To support remote operations and emergency readiness, hospitals and the military often freeze red blood cells, which transport oxygen, and plasma, a protein-rich fluid that helps restore blood volume and supports coagulation. Once thawed, however, both products must be used quickly, expiring within days. “What happens if I don’t know when I’m going to be attacked? Well, thaw it and you let it expire,” Murray says.
Time pressure compounds the logistics problem. A JAMA analysis of combat injuries in Afghanistan suggests there is a critical window: for patients who require transfusion, treatment ideally begins within about 36 minutes.
Murray—who also holds a PhD in physiology—is now leading DARPA’s push to reengineer the blood supply for these realities. He oversees a new $73 million initiative called RAPIID, short for “resuscitation and prevention of ischemia-induced dysfunction.” The program aims to create shelf-stable versions of the three primary transfusion components: plasma, platelets, and red blood cells. Launching in earnest later this year, RAPIID builds on decades of attempts to synthesize blood or preserve it longer, including DARPA’s earlier $47.5 million FSHARP program (“fieldable solutions for hemorrhage with bio-artificial resuscitation products”), which produced encouraging animal results.
Under RAPIID, multiple component-specific trials are planned to run in parallel. The target is ambitious: by 2029, the program aims to have deployable bags of dried blood products ready for use in the field. That timeline puts Murray in the role of both scientific coordinator and systems engineer—aligning clinical trial pathways with the US Food and Drug Administration while ensuring the supporting infrastructure exists, from ruggedized storage bags to diagnostics that can estimate how much artificial blood a patient has already received.
The work is daunting, but the impetus is growing. In a mass-casualty event, relying on traditional blood drives and conventional supply chains may not be fast—or predictable—enough.
Why it matters
Blood’s short shelf life and complex logistics leave both civilian hospitals and frontline medics struggling to deliver transfusions when minutes count. If shelf-stable plasma, platelets, and red cells can be safely fielded, emergency care could shift from scarce, time-sensitive donations to stockpiled products available on demand. The next major test will be whether these components can prove effective in trials and move through FDA review quickly enough to meet the military’s 2029 deployment goal.