People in the ancient times were ignorant of the reverse idea of saving life of someone dying for the want of blood by transfusing it after collecting it from some other healthy volunteer. During those times, this field needed a lot of technological advances. In 1492, when Pope Innocent VIII was dying, he was administered blood collected from three young persons.
The idea was to treat Pope’s senility or to return his youth. Unfortunately, all four persons died. That was the first description of blood transfusion rather mismatched blood transfusion, in human civilisation. Since 17th century, many such practices have come to existence.
Andreas Libavius, a German physician and chemist, in 1615, introduced a system through which blood transfusion was possible. According to him, blood can be transferred from one person’s vein to another person, who is exhausted, weak, enervated and scarcely breathing. In 1704, another experiment was conducted, in which twice the blood was transfused to a dying person by collecting it from a calf.
However, after the second transfusion, the patient developed an unnatural feeling, the cause of which is still unknown. The successful blood transfusion from human to human was carried out by British obstetrician James Blundell. He transfused blood from human volunteers to dying patients. In some cases, his attempts were very successful, he was able to give a fresh lease of life, but a few of the patients lost their lives. He was unable to explain the cause of death due to blood transfusion.
In 1900, Austrian biologist and physician Karl Landsteiner first invented ‘ABO blood group system’. He was also able to explain scientifically the side effects of blood transfusion like ‘haemolysis’ and ‘incompatibility’. Later, he received the Nobel Prize for his discovery. He is the ‘father of modern transfusion medicine’.
Ludvig Hektoen, a noted American Physician improved blood safety by introducing cross-match technique. The discovery of Sodium Citrate in 1914 by A. Hustin and L. Agote, was a landmark invention in blood transfusion. Blood collection, blood preservation and blood transfusion to ailing humanity was made possible with this discovery. In 1916, Francis Rous and JR Turner experiments proved that glucose can increase the life span of red blood corpuscles of stored blood. J Loutit and P Mollison in 1943 discovered Acid Citrate Dextrose (ACD) which can preserve blood up to 21 days. In 1921, blood donation programs started officially. In 15th March, 1937, first blood bank started in Chicago city in Cook County Hospital under the supervision of Dr. Bernard Fantus.
By 1940, a lot of blood banks opened. At that time, there was direct transfusion, patient and donor both used to lie down side by side during transfusion or donation like sometimes we see in Hindi movies. An outbreak of Syphilis happened due to direct transfusion among recipients and later on, this test (no name of the blood test) became mandatory in collected blood for transfusion.
The discovery of RH-typing in blood by Landsteiner and Weiner explained transfusion reaction of some patients as well as Haemolytic disease of the newborn and their remedy was also made possible later on. After that a lot of blood group antigen systems were discovered by several scientists. World War II (1939 – 1945) opened many closed doors of transfusion medicine. Blood component preparation from whole blood became possible. Everybody accepted the importance of transfusion medicine as a branch of medical science. Blood and its components became extremely useful life saving drug for wounded soldiers. At that time blood transfusion facility was limited among soldiers.
Altogether, there are 30 blood group systems, 308 blood group antigens and 1140 blood group alleles till date. Around 1940, common people also became the beneficiary of transfusion medicine. Later on, it was that observed haemophiliac patients are cured with fresh plasma transfusion; new born babies who have suffers from jaundice are cured with Exchange transfusion. With the passing time, from 1960- 65, plastic polyvinyl blood collection bags containing citrate phosphate dextrose adenine (CPDA) were introduced into the market. It was easy to collect store blood in this container in hygienic way. Blood component preparation was also made easy.
Rational use of blood / Component therapy is the cornerstone of modern blood banking. In modern transfusion medicine, the importance lies on separation of blood into different components and use of blood components according to its necessity. It has been beneficial first, because there is less chance of transfusion reaction among recipients.
Second, one unit of blood can be divided into more than one component and can be transfused to more than one patient according to their necessities and thus wastage is prevented. And thirdly, plasma, which is a component of blood, can be stored up to one year.
Discovery of HIV and Hepatitis B virus made the blood test mandatory. Available at the Kolkata blood banks, the technique of Apheresis has made the procedure of blood transfusion easy. In this process, a particular component of blood as much a patient requires from a donor with the help of a machine and return the rest to the donor. Hence, more than one unit of blood component can be collected from a single donor.
At present, medical is also the technique, Intraoperative Blood Salvage, blood lost in the surgical process of a patient can be collected and stored and transfused back to the patient. There is a hope that the progress of modern transfusion medicine will gain momentum in the years to come and it is dedicated to the betterment of ailing humanity.
(MOIC, Blood Bank, Fortis Hospitals Limited)