HIGHTLIGHT OF TRANSFUSION MEDICINE HISTORY
English physician William Harvey discovers the circulation of blood. Shortly afterward.
the earliest known Blood transfusion is attempted
The first recorded successful blood transfusion occurs in England: Physician Richard
Lower keeps dogs alive by transfusion of blood from other dogs.
Jean-Baptiste Denis in France and Richard Lower in England separately report successful
transfusions from lambs to humans. Within 10 years, transfusing the blood of animals
to humans becomes prohibited by law because of reactions.
In Philadelphia an American physician, Philip Syng Physick, performs the first human
blood transfusion, although he does not publish this information.
James Blundell, a British obstetrician, performs the first successful transfusion
of human blood to a patiel1l fur the treatment of postpartum hemorrhage. Using the
patient's husband as a donor, he extracts approximately four ounces of blood from
the husband's arm and, using a syringe, successfully transfuses the wife. Between
1825 and 18.10, he performs 10 transfusions, five of which prove beneficial to his
patients, and publishes these results. He also devises various instruments for performing
transfusions and proposed rational indications
At St. George's School in London, Samuel Armstrong Lane, aided by consultant Dr.
Blundell, performs the first successful whole blood transfusion to treat hemophilia.
English surgeon Joseph Lister uses antiseptics to control infection during transfusions.
US physicians transfused milk (from cows, goats and humans).
Saline infusion replaces milk as a "blood substitute" due to the increased frequency
of adverse reactions to milk.
Karl Landsteiner, an Austrian physician, discovers the first three human blood groups,
A, B and O. The fourth, AB, is added by his colleagues A. Decastello and A. Sturli
in 1902. Landsteiner receives the Nobel Prize for Medicine for this discovery in
1930.
Hektoen suggests that the safety of transfusion might be improved by crossmatching
blood between donors and patients to exclude incompatible mixtures. Reuben Ottenberg
performs the first blood transfusion using blood typing and crossmatching in New
York. Ottenberg also observ'ed the mendelian inheritance of blood groups and recognized
the "universal" utility of group O donors.
French surgeon Alexis Carrel devises a way to prevent clotting by sewing the vein
of the recipient directly to the artery of the donor. This vein-to-vein or direct
method. known as anastomosis, is practiced by a number of physicians, among them
J. B. Murphy in Chicago and George Crile in Cleveland. The procedure, however, proves
unfeasible for blood transfusions, but paves the way for successful organ transplantation,
for which Carrel receives the Nobel Prize in 1912.
Moreschi describes the antiglobulin reaction.
Roger Lee, a visiting physician at the Massachusetts General Hospital, along with
Paul Dudley White, develops the Lee-White clotting time. Adding another important
discovery to the growing body of knowledge of transfusion medicine. Lee demonstrates
that it is safe to give group 0 blood to patients of any blood group, and that blood
from all groups can be given to group AB patients. The terms "universal donor" and
"universal recipient" are coined.
Long-term anticoagulants, among them sodium citrate, are developed, allowing longer
preservation of blood
At Mt. Sinai Hospital in New York. Richard Lewisohn uses sodium citrate as an anticoagulant
to transform the transfusion procedure from direct to indirect. In addition, R.
Weil demonstrates the feasibility of refrigerated storage of such anticoagulated
blood. Although this is a great advance in transfusion medicine, it takes 10 years
for sodium citrate use to be accepted.
Francis Rous and J.R. Turner introduce a citrate-glucose solution that permits storage
of blood for several days after collection. Allowing for blood to be stored in containers
for later transfusion aids the transition from the vein-to-vein method to direct
transfusion. This discovery also allows for the establishment of the first blood
depot by the British during World War I. Oswald Robertson is credited as the creator
of the blood depots.
The MNSs and P systems are discovered.
The first blood bank is established in a Leningrad hospital.
Bernard Fantus. director of therapeutics at the Cook County Hospital in Chicago,
establishes the first hospital blood bank. In creating a hospital laboratory that
can preserve and store donor blood, Fantus originates the term "blood bank." Within
a few years, hospital and community blood banks begin to be established across the
United States. Some of the earliest are in San Francisco, New York. Miami and Cincinnati.
The Rh blood group system is discovered by Karl Landsteiner, Alex Wiener. Philip
Levine and R.E. Stetson and is soon recognized as the cause of the majority of transfusion
reactions. Identification or t he Rh factor takes its place next to ABO as one of
the most important breakthroughs in the field of blood banking.
The United States government established a nationwide program for the collection
of blood Charles R. Drew develops the "Plasma for Britain" program. The American
Red Cross participates, collecting 13 million units of blood by the end of World
War II.
sodor Ravdin, a prominent surgeon from Philadelphia, effectively treats victims
of t he Pearl Harbor attack with Cohn's albumin for shock. Injected Into the blood
stream, albumin absorbs liquid from surrounding tissues, preventing blood vessels
from collapsing, a finding associated with shock.
The introduction by J. F. Loutit and Patrick L. Mollison of acid citrate dextrose
(ACD) solution, which reduces the volume of anticoagulant, permits transfusions
of greater volumes of blood and permits longer term storage.
P. Beeson publishes the classic description of transfusiontransmitted hepatitis.
Coombs, Mourant and Race describe the use of antihuman globulin (later known as
the ''Coombs Test") to identify "incomplete" antibodies.
The American Association of Blood Banks (AA13H) IS formed to promote common goals
among blood banking practitioners and the blood donating public.
The US blood collection system includes 1500 hospital blood banks, 46 community
blood centers and 3 I American Red Cross regional blood centers.
Audrey Smith reports the use of glycerol cryoprotectant for freezing Red Blood Cells.
In one of the single most influential technical developments in blood banking, Carl
Walter and W.P. Murphy, Jr., introduce the plastic bag for blood collection. Replacing
breakable glass bottles with durable plastic bags allows for the evolution of a
collection system capable of safe and easy preparation of multiple blood components
from a single unit of whole blood Development of the refrigerated centrifuge in
1953 further expedites blood component therapy.
The AABB Clearinghouse is established, providing a centralized system for exchanging
blood among blood banks. Today, the Clearinghouse is called the National Blood Exchange
In response to the heightened demand created by open heart surgery and advances
in trauma care patients, blood use enters its most explosive growth period.
The AABB forms its committee on Inspection and Accreditation to monitor t he implementation
of standards for blood banking.
The AABB publishes its first edition of Standards for a Blood Transfusion Service
(now titled Standards for Blood Banks and Transfusion Services).
Max Perutz of Cambridge University deciphers the molecular structure of hemoglobin,
the molecule that transports oxygen and gives Red Blood Cells their color.
The AABB begins publication of TRANSFUSION, the first American journal wholly devoted
to the science of blood banking and transfusion technology. In this same year, A.
Solomon and J.L. Fahey report the first therapeutic plasmapheresis procedure
The role of platelet concentrates in reducing mortality from hemorrhage in cancer
patients is recognized.
The first antihemophilic factor (AHF) concentrate to treat coagulation disorders
in hemophilia patients is developed through fractionation.
In the US, there were 4400 hospital blood banks, 123 community blood centers and
55 American Red Cross blood centers, collecting a total of five to six million units
of blood per year.
Plasmapheresis is introduced as a means of collecting Plasma for fractionation.
Judith G. Pool and Angela E. Shannon report a method for producing Cryoprecipitated
AHF for treatment of hemophilia.
Rh immune globulin is commercially introduced to prevent Rh disease in the newborns
of Rh-negative women.
S. Murphy and F. Gardner demonstrate the feasibility of storing Platelets at rool11
temperature, revolutionizing platelet transfusion therapy.
Blood banks move toward an all-volunteer blood donor system.
Hepatitis B surface antigen (HBsAg) testing of donated blood begins.
Apheresis is used to extract one cellular component, returning the rest of the blood
to the donor.
A new anticoagulant preservative, CPDA-I, extends the shelf life of Whole Blood
and Red Blood Cells to 35 days, increasing the blood supply and facilitating resource
sharing among blood banks.
With the growth of component therapy, products for coagulation disorders and plasma
exchange for the treatment of autoimmune disorders, hospital and community blood
banks enter the era of transfusion medicine, in which doctors trained specifically
in blood transfusion actively participate in patient care.
Additive solutions extend the shelf life of Red Blood Cells to 42 days
The first blood screening test to detect HIV is licensed and quickly implemented
by blood banks to protect the blood supply.
Human T Lymphotropic Virus I antibody (anti-HTLV-I) testing of donated blood begins.
Introduction of first specific test for hepatitis C, the major cause of "non-A,
non-B" hepatitis, although the hepatitis C virus (HCY) has never been isolated.
Testing of donor blood for HIV-I and HIV-2 antibodies (anti-HIV-I and anti-HIV-2)
is implemented.
HIV p24 antigen testing of donated blood begins. Although the test does not completely
close the HIV window, it shortens the window period.
US Government issues two reports suggesting ways to improve blood safety, including
regulatory reform.
HCY lookback campaign begins.
Blood community begins implementation of Nucleic Acid Amplification Testing (NAT)
under the FDA's Investigational New Drug (IND) application process. NAT employs
a testing technology that directly detects the genetic materials of viruses like
HCV and HIV