THE HISTORY OF BLOOD TRANSFUSION.


Spread the love

The history of blood transfusion has been marked by high expectations, unexpected complications, and impressive advances in lifesaving supportive care. Since the seventeenth century and the first transfusion of blood from sheep to man.

The first successful indirect human transfusion, using a syringe to transfer blood from donor to recipient, is attributed to the English obstetrician James Blundell in1818. Blundell cautioned that transfusion should be reserved for patients in extremis. Mortality in his series approached 50%, although the mortality related to transfusion of incompatible blood always remains unknown.

During the era of modern transfusion medicine dates to the early twentieth century, with the identification of the blood groups A, B, and O by Landsteiner in 1901. Subsequent use of this technique for compatibility testing improved blood safety dramatically, although recognition of the immunologic diversity of red blood cells and sophisticated cross matching had to await the discovery of the direct antiglobulin (Coombs) test almost 50 years later (Coombs, 1945).

In addition,the development of anticoagulant (1914) and preservative solutions (1916) led to the establishment of World War I blood depots in British Casualty Clearing Stations, precursors of the modern blood bank, where blood could be stored after collection for several days prior to use (Robertson, 1918).

The quality of these cells was not documented, but by all reports these early transfusions saved people’s lives (Hess and Schmidt, 2000). Ironically, no controlled studies of the effectiveness of whole blood or red cell transfusions have ever been conducted, and no trials are likely to be done.

Under the era of component therapy dates from the development of the plastic blood bag in 1953 and the development of interconnected systems of bags in the 1960s, which not only permitted efficient use of collections from a single donor, but also decreased the risks of bacterial contamination and volume overload from transfusion (Walter, 1984).

At about the same time, blood transfusion-transmitted hepatitis, recognized since World War II, was reported as an inordinately high risk in recipients of blood from commercial sources.

As a result, developed countries have almost universally instituted all volunteer blood donation systems. But the challenges of avoiding pathogen transmission through blood have moved to the forefront of blood safety. Until this time the blood transfusion is conducted and saves the lives of pregnant and other patients. This is achieved by the government campaigns of blood donation.