1) The first successful human blood transfusion was performed in 1667 by Jean-Baptiste Denis, transfusing sheep's blood into a 15-year old boy in Paris. However, the practice was controversial and banned within 10 years. 2) In the early 19th century, James Blundell pioneered the use of human-to-human blood transfusions using syringes, establishing it as a viable medical practice. 3) Karl Landsteiner's discovery of the three main blood groups in 1901 was a major breakthrough, allowing safer matching of donor and recipient blood and preventing fatal transfusion reactions.

1. A B R I E F H I S T O R Y O F T R A N S F U S I O N
Blood Transfusion Science

2. MYTHS MYSTICS AND RITUALS
• In the bible: leviticus 17:11
The life of the flesh is in the blood
The circa 100BC (Chinese
Neiching)
The blood contains the soul

3. MYSTICS RITUALS AND MYTHS
BLOOD LETTING
 The Romans
 Drank gladiators blood to cure epilepsy
 Taurobolium (blood bath for spiritual restoration) the pit or
fossa sanguinis
 Egyptians
 Blood baths for recuperation
 American Indians
 Blood Letting as a source of self-punishment

4. MYTHS MYSTICS AND RITUALS
Myths
 The legend of Medea and Aeson taken from Ovid’s
Metamorphoses and quoted in Bulfinch’s Mythology
 Jason asked medea to take afew years of his life
and add to his father’s (Aeson) But what does
Medea do?
 Pope innocent VIII of 1492 and the Three
10year old boys

5. Ancient beliefs
 Early Greeks held that blood was formed in the heart,
flowed through veins and consumed by the body
 Arteries were only transporters of air
 Erasistratos (circa 270 BC) believed that the heart was
a pump! That was way beyond his time…….!
 Galen advised that the drinking of Dog’s blood cured
epilepsy!
 Egyyptians believed it to be a cure for elephantiasis!
 The Vikings reportedly drank whale and seal blood as
cure for scurvy and epilepsy!

6. Blood Circulation
 Errors that masked the discovery of circulation
 Arteries contained only air and no blood
 The septum between the heart chambers was perforated
 Veins carried blood away from the heart
 Sushtra in the 6th century BCE showed knowledge of circulation
 Aristotle in 350 BCE described the heart as the central organ of
the heart
 Herophilos and Erasitratus showed that when cut during life
they bleed.
 Ibu Al Nafis accurately described pulmonary blood circulation in
1242

7. Discovery of the blood circulation
 Galen (131-201AD) discovered the blood also flowed
in the arteries
 And we still believed that the arteries and veins were
dead ends for the next 1400years!
 Well until 1628 when Harvey discovers the
circulation!

8. Blood Cells
 Jan Swammerdam (1658) described the red blood
cells, Anton Van Leewenhoek (1674) also did.
 Max Shultze described the platelets while in
addition, Giulio Bizzozero showed blood clumps at
site.
 Paul Ehrlich formulated blood cell staining dyes
(Nobel prize!)
 1959 Max Perutz demonstrated the structure of Hb

9. Circulatory system
 Galen also Identified arterial and venous blood
 Ibn al-Nafis, Michael Servetus and Realdo Colombo all
showed that blood circulated via both arteries and veinns
 William Harvey described the venous valves and
their functions
 Marcello malpighi discovered the capillary system
 Gaspare Aselli discovered the lymphatic circulation

11. The circulation system
 The discovery caused scientists to experiment with
vascular infusions!
 In 1642 George von Wahrendorff injected wine
 1656 Christopher Wren and Robert Boyle injected
opium and other drugs
 Richard Lower then took it a further step…….

12. First animal Transfusion
 Lower transfused dogs by inserting a quail in the
carotid artery of one dog and the jugular vein of the
other.
 He reports that the transfused dog would jump off
the table as if nothing had happened!
 KSPCA!!!!

13. Human transfusions
 Pope Giovanni Cibo between 1490 and 1492 three
young boys either were transfused or the pope drank
their blood
 In 1615 Andreas Libavius imagined and wrote about
blood transfusions but never performed any.
 In 1628 harveys work on the transfusion practice
were published.

14. Human Transfusion
 Presently these inevitably turned to Man and on
23rd November 1667
 Lower and Edmund king performed this on Mr.
Arthur Coga using sheep blood! Using sheep
blood!!! For 20 shillings!!!!
 Oh! But 6 months earlier Jean-Baptiste Dennis had
done the same after studying Lower’s experiments
for a month!!!
 So the 1st animal to Human transfusion was on June
15th 1667!!

15. Why Animal blood
 In those days. Moods were associated with blood!
 Melancholy, Envy, Sadness, Calmness, Rowdiness!!
• And therefore animal blood did not have these impurities!!
• Sheep blood transfused to a 15yr old boy
• The boy had been bled 20times! Hence profound anaemia.
When transfused there were no adverse effects!!

16. The tussle
 The French and the Britons tussled over who
performed the 1st human transfusion!
 Dennis’s letter of successful transfusion was re-
serialized by the British publisher!

17. The fourth patient
 Mr. Anthony du Mauroy! A maniac who beat his wife
incessantly!
 The first transfusion had no effect and a second one 2
days latter!
 Classic transfusion reaction results
 After 2 months du Mauroy again became maniacal and
the wife requested another transfusion therapy
 Madame du Mauroy insisted until Dennis agreed
 Before the transfusion was done du Mauroy died!!

18. Malpractice
 Some Paris physicians were unhappy with the
transfusions
 A malpractice suit
 Madame du Mauroy the extortionist!!
 The Charge of arsenic poisoning
 The Verdict!!

19. The Verdict
 A blow to further transfusion research; judgment
handed down at the Chatelet in Paris on April 17,
1668, The court stipulated “that for the future no
Transfusion should be made upon any Human Body
but by the approbation of the Physicians of the
Parisian Faculty.
 Research went into decline, and within 10 years it
was prohibited in both France and England.
 In 1679 the Pope also joined in advocating a ban
 Blood at the time was considered only for restoration
of mental health, or for youth and vigor to the ages

20. 150 years later
 James Blundell (1790-1877) an obstetrician stated
that lives that would otherwise be saved by
transfusion were being lost!
 Blundell introduced transfusion by the syringe and
stated that only human blood for Humans!
 Out of 10 transfusions 5 were successful while in five
the patients died.
 Most were on the throes of death

21. Human to Human Transfusion
 The first 1818 with the aid of dr. Henry Crine Noyes
 Dr. Blundell also devised implements used for
transfusion including
 The impeller
 The gravitator

22. Blundell’s gravitator

23. Early transfusions
 Blundell confined his cases to 1st class cases only
 Challenges like coagulation were prevalent
 The amount of blood given was not measurable
 Defibrinated blood was used to circumvent the
problem of coagulation
 It was difficult to detect reactions as these cases were
terminal

24.  Dr John Henry Leacock showed that blood was safer
when transfused only within Species not across.
 It was the works of Dr. Henry that inspired Blundell
to continue with transfusion in extreme cases of
Haemorrhage

25.  Due to the frustration occasioned by the failure of
blood transfusions, physicians resorted to bizarre
practices.
 These included
 Transfusion of
 Cow milk
 Goat
 And Human Milk.

26.  Further medical catastrophe was averted by the
discovery of saline as replacement for plasma.
 Saline was viewed as a substitute for blood
transfusion
 This volume replacement diverted attention from
blood transfusion for sometime until interest was
rekindled at the turn of the 20th century

27. The 20th century
 In 1901 Karl Landsteiner discovered the three blood
groups and named them A, B and C.
 Landsteiner noticed that sera from some individuals
agglutinated red cells of others.
 In 1902 Decarstello and Sturli found a fourth blood
group! These early scientists also contributed to
forensic science by designing a method for blood
typing using dried blood

28.  Jan Jansky and Dr. Moss also found these blood groups
independently in Czechoslovakia and the United States.
 It was not until 1907 when the impact of the
discoveries was felt
 Dr. Richard Weil started systematic pre-transfusion
grouping in 1907 in New York.
 Jansky and Moss gave roman numerals to Identify the
groups this confused and complicated the discoveries
and were to be abandoned in 1927 after the American
society of Immunologists adopted Landsteiner’s
method of nomenclature.
 Indeed the blood group C of Landsteiner was renamed
O

29.  Although Ludvig Hektoen and Reuben Ottenberg
exhaustively advocated for crossmatch and showed
the absolute value in transfusion, even now some
professionals still doubt the value of crossmatching.
 Dr. Felix Bernstein in 1924 proved the theory of
blood group inheritance conclusively.
 Felix’s pattern was however manipulated in
Germany in world war I & II and as a tool of
segregation in the US

30. Other contributions
 The transfer of blood from one individual to another
proved oft difficult. Due to clotting of blood
 Direct anastomosis was possible by the discovery of
Carrel (end to end vascular anastomosis with triple
threaded suture material.
 Crile introduced a metal tube to facilitate suture
insertion
 Bernheim introduced a two piece cannular
 Yet in all these there was still danger of Collapse of the
donor and death

31.  For the first time in Ottenberg’s transfusions, it was
possible to Identify transfusion reactions.
 He also showed the Universality of blood group O
donors

32. Further discoveries
 Between 1927 and 1947 M, N and P systems were
described.
 In 1939 Levine and Stetson showed that blood group O
transfused to a blood group O patient resulted in a still
birth when the child was the fathers blood group.
 Landsteiner and Weiner showed that an anti-body
harvested from a rabbit sensitized with Rhesus monkey
blood agglutinated 85% of human red cells and not 15%.
These results correlated with those of Levine and Stetson
 The Rh system was discovered thus

33.  The use of nomenclature has evolved to date from
Landsteiner to The International Society of Blood
Transfusion system in Current use.
 Notable discoveries also included the introduction of Rh
Immune Globulin.
 The antiglobulin test was discovered by Carlo Moreschi
in 1908, rediscovered by Dr Robin Coombs, Rob Race
and Arthur Mourant in 1945

34. Anticoagulants blood Banking and component
therapy
 Citrates were in use at 5% concentrations which were
toxic to Humans.
 Notable contributions from Dr. Weil, Dr. Lewisohn,
Rous & Turner, Loutit & Mollison all were involved
in the design of anticoagulants that proved
successful in the world war two.

35.  The first transfusion service was organized by the
republican army during the Spanish civil war of 1936-
1939
 About 9000litres in citrate-dextrose anticoagulant was
collected
 Fantus, developed the concept of a blood bank at the
same time in Chicago.
 A regional concept of Blood banking was already in
existence in Britain at the beginning of the 2nd world war
 In America The American Red cross Organized the
largest National program for blood banking

36.  At this time the needles used were all steel, the blood
bottles were made of glass and were washable,
sterilized and reusable.
 Plasma fractionation was also developed at this time
 The dawn of a golden age of patient care with specific
products was upon us!!
 But woe unto us! The HIV virus hit us like a bomb!

37. Transfusion in the current
 During the golden age of transfusion, nearly all
procedures were done with blood transfusion
 The discovery of disease in donated blood dealt a
huge blow to this.
 HIV, HCV, HBV, Syphilis among others have cast a
huge shadow on blood transfusion.
 The availability of blood has also been a major
constraint in transfusion

38. Today
 The public today is aware of blood safety and will
demand zero risk for transfusion
 This has led to increased surveillance of blood and
diseases, Hemovigilance and a marked increase in
the tools of detection of disease.
 DNA testing and other sophisticated methods have
also been used.