This document summarizes the history of blood transfusion from ancient beliefs and practices to modern developments. Key points include: - Ancient Chinese and Greeks associated blood with life and personality traits. Early transfusions from animals to humans were attempted. - In the 15th century, William Harvey discovered the circulation of blood. Later discoveries included the capillary system and lymphatic vessels. - The first successful human-to-human transfusion was performed by James Blundell in 1818. Karl Landsteiner discovered the main blood groups in 1900. - During World Wars I and II, advances allowed for blood typing, long-term storage, and establishment of the first blood banks and deposits. - Modern developments

1. Associate professor, Umesh Prasad Gupta

2. History of Blood transfusion
Blood is associated with a large number of beliefs. One of the most basic is the use of blood as a symbol for family
relationships; to be "related by blood" is to be related by ancestry or descendance, rather than marriage. This bears
closely to bloodlines, and sayings such as "blood is thicker than water" and "bad blood", as well as "Blood brother".
Christians believed that life of living being is located in his blood. "…the life of the flesh is in the blood…" (Leviticus
17:11)
In 1000 BC the Chinese believed that the soul was contained in
the blood.
In classical Greek medicine, blood was associated with air, springtime, and with a merry and gluttonous (sanguine)
personality. It was also believed to be produced exclusively by the liver.
Egyptian bathed in blood for their health.
Romans were dinking blood of fallen gladiators to gain strength and vitality.

3. Pope Innocent VIII (1432-1492)
"First Transfusion" In 1492, Pope Innocent VIII is said to have
received, at the behest of a Jewish physician, a transfusion of the
blood of three ten year old boys, each of whom was paid a ducat and
all of whom died. Probably the blood was drawn, but was intended to
be taken orally. Indeed, there is no reliable evidence that the sickly
pope accepted the blood at all.
History of Blood transfusion

4. The discovery of the circulation of the blood didn't belong to a
single man, or indeed to a single era.
Discovery of Blood circulation
Blood created in liver and
heart. He mistakenly assumed
that air caused pulse. Blood
flowed from both creating
organs to all parts of the body
where it was consumed and
there was no return of blood to
the heart or liver.

5. Discovery of Blood circulation
The Fifteen Century; William Harvey, a British Physician is
credited with the discovery of the circulation of blood as we
know it today. (De Motu Cordis published in 1628)
This book of one hundred pages is considered by many as a
master piece and its exposition slowly convinced the medical
world. He discovered the real function of cardiac and venous
valves. Besides, He concluded that arterial pulsation is only due
to blood. He never discovered the capillary system. He also
contributed to the discovery of the circulation in fetus.
The Italian physician Marcello Malpighi (1628-1694)
completed Harvey‟s work and discovered the capillary system
connecting arteries and veins.
Gaspare Aselli, or Asellio (1581-1626) an Italian physician,
was noted for the discovery of the lacteal vessels of the
lymphatic system in 1622. The Ancients knew nothing of the
lymphatic vessels.

6. The Seventeenth Century* In 1665 ,Richard Lower is credited
with performing the first Successful blood transfusion (animal
to animal).* He kept exsanguinated dogs alive by connecting
the carotid artery of the donor dog to the jugular vein of the
recipient dog with a quill.
Denis and Emmerez performed transfusion of lamb blood into
the carotid artery of a young woman in 1667.
•Denis did similar transfusions on a 15 yr old boy and later a
labourer both of them survived.
• Denis's fourth transfusion recipient, suffering from luetic
madness, following a symptom-free first transfusion. developed
a hemolytic reaction upon his second transfusion His madness
seemed improved, so another transfusion was undertaken which
unfortunately proved fatal.
History of Blood transfusion

7.  This fetal death incident led to a prohibition by the French
Parliament of further transfusions (1678).
 The British Royal Society (1668) and the Vatican (1669)
had also laid prohibitions against blood transfusions.
 These prohibitions and the fear of adverse reactions led to a
150 year long near complete hiatus in transfusion work.
Prohibition of blood transfusion

8. The Eighteenth Century Transfusions were done only
sporadically, and were generally animal to human. Transfusion
was generally thought of as a cure for mental aberration or as a
youth potion for the aged, rather than as a treatment for blood
loss.
Animal to human blood transfusion

9. Human to Human Blood transfusion
James Blundell*
In 1818, James Blundell attempted human-to human
transfusion of a man suffering from gastric carcinoma.* He also
successfully transfused a patient who had hemorrhaged during
childbirth
Diagram of The ‘Impellor’ of Blundell which appeared in his book, published in 1824

10. J.Roussel. 1865. He had first used his method of direct arm to
arm transfusion with success in 1865 for a patient with
puerperal haemorrhage.
Human to Human Blood transfusion
In 1882, in Paris a total of sixty transfusions performed since
1865 in Switzerland, Austria, Russia, Belgium, England and
France. Roussel's „transfuseur‟ apparatus was subsequently
officially adopted for use by the French Army and apparently
used in time of war.
Throughout the 19th century, the main use of transfusion was however in the treatment of
obstetric cases. Beyond this fact, a number of major practical problems are sever transfusion
reaction and infection.
 1867 - English surgeon Joseph Lister utilized antiseptics to control infection
during Blood transfusions.
 1873 to 1880 - Physicians in the United States are documented, during these
years, to have transfused milk (from cows and goats) to humans.
 1884 - Saline infusion replaced milk as a 'Blood substitute' due to increased
frequency of adverse reaction to milk.

11. Karl Landsteiner 1930 Nobel Prize Laureate•
In 1900-01, Landsteiner showed that serum from some individuals
could agglutinate or hemolyze the red blood cells of certain, but not
all, individuals. The serum of the latter would likewise agglutinate the
red blood cells of the former.• He named these three different types A,
B, and C. Today these are types A, B, and O
Human to Human Blood transfusion
 Sturli and DeCastello described the fourth blood grou AB, in
1902.
 Landsteiner and Wiener, in 1940, describe Rh typing. This leads
to dramatic decrease in the incidence of hemolytic disease of the
newborn.
 Over 250 different antigens categorized into 23 major discrete
systems are now known.

12. In 1914, Albert Hustin reported the first human transfusion
using citrated blood, he added sodium citrate and glucose to
preserve blood.
American Surgeon Reuben Ottenberg and Schultz were the
first to apply this information in an actual transfusion (1907).
He suggested that patient and donor blood should be grouped
and cross matched.
Human to Human Blood transfusion

13. The introduction of a citrate dextrose solution permitted the storage of blood in
containers for several days thus opening the way for the first "Blood Depot" in
Britain during World War I
Oswald Hope Robertson, a medical researcher and US army officer, who
established the Depot is now recognized as the creator of first blood bank.•
World War I experiences led to the universal adoption of blood typing to select
blood donors.
First Blood Depot.
Rous and Turner developed a solution of salt, isocitrate and dextrose in order to
both anticoagulate and preserve blood.
• This method, with minor variations, was used through most of World War II.•
Loutit and Mollison introduced ACD (acid-citrate-dextrose) as a preservative in
1943.* It was adopted by the Army in 1945.(1:4 solution:blood ratio)

14. Dr. Charles Drew was an African-American doctor and scientist.
His work on blood storage and blood banks helped to save
thousands of lives during World War II. He developed ways to
process and store blood plasma.
Separation of Blood component

15. Edwin Cohn* In 1940, Edwin Cohn developed cold ethanol
fractionation, the process of breaking down plasma into
components and products.*
In 1951, Edwin Cohn developed the first cell separator which
allowed blood to be separated into red cells, white cells,
platelets, and plasma
Separation of Blood component
In 1936,During the Spanish Civil War, Dr. Norman Bethune,
established the first Blood Bank at Madrid. Bernard Fantus, at
Chicago's Cook County Hospital, established the first hospital
blood bank in the United States on 15 Mar1937.
Blood Bank

16.  In 1952, Dr Carl Waldemar Walter, of Harvard Medical Sch
is credited with the invention of the first Plastic blood
collection bag.
 Plastic bags were disposable and, because of their flexibility,
facilitated the separation of blood components and the advent
of component therapy.
Blood Bank
In 1964, Plasmapheresis was introduced for the means of
collecting plasma for fractionation.
Judith Pool develops cryoprecipitate for the treatment of
Hemophilia.•
In 1969, S. Murphy and F. Gardener demonstrated the
feasibility of storing platelets at room temp, revolutionizing
platelet transfusion therapy•
In 1981, use of polyvinyl bags for collection, storage and
transfusion was legalized.

17.  ACD preservative was supplanted by citrate-phosphate
dextrose (CPD) in 1957.
 CPD with adenine in 1965.
 CPD-A1 in the 1980s.* Effective preservation and
refrigeration lead to the ability to bank blood for longer
periods.
 Cryoprotective agents, such as glycerol, gain use in the
1960s, enabling freezing of blood for long-term storage.
Blood Bank

18. 1985 - The first Blood screening test to detect the probable presence of HIV was licensed and implemented
by Blood banks in the United States.
1987 - Two tests for screening for indirect evidence of hepatitis C were developed and implemented:
hepatitis B core antibody (anti-HBc) and the alanine aminotransferase test (ALT).
1992 - Testing of donor Blood for HIV-1 and HIV-2 antibodies (anti-HIV-1 and anti-HIV-2) was
implemented.
1996 - Testing of donated Blood for the HIV p24 antigen began. The test did not do a complete job, but
improved on the previous tests, in that, the time taken to clear donated Blood for use was shortened
substantially.
1996 and 1997 - The United States Government issued reports suggesting problems with the Blood supply
in the United States, and suggested methods and procedures to improve Blood safety, including regulatory
reform.
1999 - The Blood manufacturing community began 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.
History of Blood transfusion