BRIEF HISTORY OF TRANSFUSION MEDICINE

1. HISTORY OF BLOOD
BANKING
Dr Sujay Bhowmik
RESIDENT
DEPT OF BLOOD TRANSFUSION & IMMUNOHEMATOLOGY, AFMC,PUNE

2. • China, 1000 BC - The soul was contained in the blood.
• Egyptians bathed in blood for their health.
• Romans drinking the blood of fallen gladiators to gain
strength and vitality and to cure epilepsy.
• Ancient Greeks believed that blood was formed in the heart,
then consumed as it flowed out to the body in veins, while
air was passed from the lungs to the body in arteries.
Blood in History

3. • In 1492, Pope Innocent VII is said to have received, at the
behest of a Jewish physician , a transfusion of the blood of
three ten year old boys, and all of them died.
• Although the outcome was unsatisfactory, it was the first
time a blood transfusion was recorded in history.
“ The First Transfusion”

5. • 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)
The Fifteen Century

6. • 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.
The Seventeenth Century

7. • 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.
Jean Baptiste Denis

8. JEAN BAPTISE DENIS TRANSFUSION

9. In 1658, Christopher Wren and William Boyle performed
a series of experiments injecting various medicaments into the
veins of dogs utilizing a bladder with an attached quill and then
observing the effects.
Infusion solutions included wine, beer, opium, emetics, water,
nitric acid, and sulfuric acid.
Willis injected dyes into the blood vessels supplying the brain
in order to trace its vasculature (thus the Circle of Willis).
Infusion Experiments
• This 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
150year long near complete hiatus in transfusion work.

10. SCULTETUS TRANSFUSION , 1693

11. 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.

12. HASSE TRANSFUSION

13. 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

14. BLUNDELL TRANSFUSION USING GRAVITATOR

15. • Transfusions in the 1800s were plagued by the complications
of transfusion reactions.
• Panum and Landois showed that same species transfusions
were more efficacious than interspecies transfusions.
• However, animal to human transfusions were performed as
late as 1890.
• Two instances of successful transfusion, both administered
during leg amputation, are documented from the Civil War
The Nineteenth Century

16. AVELING’S TRANSFUSION , 1873

17. ROUSSELS APPARATUS FOR DIRECT TRANSFUSION

18. 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.

19. • Sturli and DeCastello described the fourth blood group,
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.
• 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.

20. Lewisohn’s Method of Transfusion(1907)
Blood is collected in a citrated flask and immediately transfused.

21. •In 1914 , Albert Hustin reported the first human transfusion
using citrated blood, he added sodium citrate and glucose to
preserve blood.

22. First Blood Depot
• 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 recognised as the
creator of first blood bank.
• World War I experiences led to the universal
adoption of blood typing to select blood donors.

24. • 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)

26. Dr . Charles Dew
• 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.

27. 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

28. Blood Banks
• 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 Mar 1937.

29. Dr. Bernard Fantus

30. • 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.

31. Plastic Blood Bags
• Blood was collected into reusable glass bottles in the first half of
the twentieth century.
• Pyrogenic reactions from contamination due to incomplete
cleaning were frequent.
• Air embolism was a common complication due to the vacuum
systems used on glass bottles.
• Trials of plastic bags were conducted by the American Red Cross
in 1949.

33. • In 1952, Dr Carl Waldemar Walter, of Harvard Medical School,
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.

34. Plastic Blood Bags and Component Separation

35. • 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 legalised.

36. Blood Banking in India
• In 1942 , the first central blood bank of India was established
at Calcutta, in the School Of Tropical Medicine by Sir
Upendranath Bramhachari , chairman of the Indian Red Cross
Society.
• In 1998, The Supreme court of India , passed a judgement on
Blood Transfusion and Blood Banking in India
• Banned buying Blood from commercial
sellers.
• National and State blood councils were
established

37. • The National Blood Policy (2002) and an Action Plan for
Blood Safety (2003) were adopted by the Government of
India.
• National Blood Transfusion Council (NBTC) was constituted
within National AIDS Control Organisation (NACO) and
similarly State Blood Transfusion Council (SBTCs) were
established within State AIDS Control Societies (SACS)

38. Blood Transfusion and Banking has come a
long way due to multiple scientists,
adventurous physicians, courageous donors
and patients . We owe much to these
pioneers.

39. THANK YOU