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A Brief History ofBlood Transfusion

الطبيب د/ عامر إمحمد – طرابلس المركزي الدم مصرف

( الشط) طريق

Pope Innocent VIII

• in 1492, Pope Innocent VIII sank into a coma, the blood of three boys was infused through the mouth, as the concept of circulation and methods for intravenous access did not exist at that time) at the suggestion of a physician.

• The boys were ten years old, However, not only did the pope die, but so did the three children.

William Harvey (1578 – 1657)

1616: William Harvey a British physician,

discovered that blood circulates throughout the body.

) النفيس (1288- 1210ابن

ويليام 300قبل اكتشاف من سنة

سنة– في أي م, 1242هارفيالنفيس ابن العربي العالم قام

الدموية الدورة باكتشاف. الرئتين و القلب بين الصغرى

Jan Swammerdam 1658

1658Amsterdam-Holland

Microscopist Jan Swammerdam was the first to observe and describe red blood cells.

Richard Lower )1631-1691)-England

• Richard Lower is credited with performing, in 1665, the first animal to animal blood transfusion .

Animal to Human Transfusion

• The first fully documented human blood transfusion was administered by Dr. Jean-Baptiste Denys, eminent physician to King Louis XIV of France, on June 15, 1667. He transfused the blood of a sheep into a 15-year old boy, who survived the transfusion.

بها • قام كامل بشكل موثقة بشرية دم نقل عملية أولدينيس بابتيست دم. 1667 يونيو 15في جان بنقل قام حيث

. عمره من عشرة الخامسة في فتى إلى خروف

Animal to Human TransfusionFirst lamb to human transfusion

Within 10 years, transfusing the blood of animals to

humans was prohibited by law because of severe reactions

James Blundell

In 1818, British obstetrician James Blundell attempted human-to human transfusion from husband to his wife suffering from postpartum haemorrhage.

Blundell’s transfusion devices:

It included the impellor (A(, which consisted of a cup, tube, and syringe; and the gravitator (B(, consisting of a receptacle held high above the patient with an attached tube through which the blood was injected into the patient.

Use of milk and saline

• 1873-1880: US physicians transfused milk )from cows, goats, and humans).

• 1884 : Saline infusion replaces milk as a “blood substitute” due to the increased frequency of adverse reactions to milk.

Karl LandsteinerWon the 1930 Nobel Prize for Medicine

Landsteiner June 14, 1868

In 1900, He showed that serum from some individuals could agglutinate the red blood cells of certain, but not all, other individuals. The serum of the latter would likewise agglutinate the red blood cells of the former. Still other individuals’ red cells were unaffected by the serum from either of these.

He named these three different types A, B, and C.

( type C was later renamed type O)1939 -1940: he discovered together with other scientists

the Rh system

Before anti-coagulation

Blundell had observed the need for rapid transfusion in order to prevent coagulation. Direct transfusion )artery to vein for speed) was advocated.

Anti - coagulation

• An early development leading to the establishment of blood banks occurred in 1915, when Richard Lewison of Mount Sinai Hospital, New York initiated the use of sodium citrate as an anticoagulant. This discovery transformed the blood transfusion procedure from direct )vein-to-vein) to indirect procedure.

Lewisohn’s Method of Transfusion

Blood is collected in a citrated flask, and then immediately transfused

Blood stored in glass bottles

• Before the manufacture of plastic blood bags in 1953, blood was collected in glass bottles which was refrigerated and reused after cleaning. Only whole blood was transfused.

• 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.

Plastic Blood Bags and Component Separation

• Blood was collected into reusable glass bottles before 1953.

• 1953 : Plastic Blood Bag Invented by the Fenwal company

• Plastic bags were disposable and, because of their flexibility, facilitated the separation of blood components and the advent of component therapy.

• At least 17 different components are available through a blood bank.

مباشر بشكل الدم لنقل جهازالثانية العالمية الحرب في استخدامه تم الجهاز هذافي المريض و المتبرع بين مباشر بشكل الدم لنقل

القتال جبهات في الطارئة الحاالت

Preservation

1943 : Acid Citrate Dextrose (ACD (: preservative allowed for blood to be stored for up to 3 weeks.

1957: citrate-phosphate- dextrose (CPD(: store blood for 3 weeks with better red cell survival.

In the 1960s : Cryoprotective agents, such as glycerol, enabling freezing of blood for long-term storage.

1979: Anticoagulant CPDA1 extends shelf life of red cells to 35 days

1983: Additive solutions extends shelf life of red cells to 42 days

Effective preservation and refrigeration lead to the abilityto bank blood.

Aphaeresis

• 1964 : Plasmaphaeresis is introduced as a means of collecting plasma for fractionation.

• 1972 : Aphaeresis was used to extract one cellular component, returning the rest of the Blood to the donor.

· 1932: the first facility, fully functioning as what would come to be known as a "Blood bank," was established in a Leningrad Russia hospital.

March 15,1937: Bernard Fantus, at Chicago’s Cook County Hospital, established the first blood bank in the United States.

The first blood bank in Libya??? المرجعي المختبرالحالي

First Blood Banks

Donated Blood Testing

1940: Serological test for syphilis ) VDRL ).

1971: Hepatitis B surface antigen )HbsAg) testing of donated blood began in USA.

1985: first test to detect HIV-1 antibody in donated blood.

1987: Anti- HBc )antibody to hepatitis B core antigen).

1989 : In the United States, human T lymphotropic virus I antibody )anti-HTLV-I) testing of donated Blood began.

1990 : Introduction of first specific test for HCV antibody.

1992 : test for HIV-2 antibody was added.

1996 : Testing of donated Blood for the HIV p24 antigen began in USA. it shortens the window period.

NAT Testing

• 1999 : Nucleic Acid Amplification Testing (NAT) : It employs a testing technology that directly detects the genetic materials of viruses like HCV ,HIV and hepatitis B virus.

• NAT has decreased the risk of infection, but did not

eradicate this risk completely.

Blood substitutes

• Till now, there are no available oxygen-carrying blood substitutes, which is the typical objective of a blood )RBC) transfusion; however, there are widely available non-blood volume expanders for cases where only volume restoration is required.

• A number of blood substitutes have been tried )and still are), but thus far they all suffer from many challenges.

Thank you