HIGHLIGHTS OF TRANSFUSION MEDICINE HISTORY

1628 English physician William Harvey discovers the circulation of blood. Shortly afterward, the earliest known blood transfusion is attempted.

1665 The first recorded successful blood transfusion occurs in England: Physician Richard Lower keeps dogs alive by transfusion of blood from other dogs.

1667 Jean-Baptiste Denis in France and Richard Lower in England separately report successful transfusions from lambs to humans. Within ten years, transfusing the blood of animals to humans becomes prohibited by law, delaying transfusion advances for about 150 years.

1795 In Philadelphia an American physician, Philip Syng Physick, claims to perform the first human blood transfusion, although he does not publish this information.

1818 James Blundell, a British obstetrician, performs the first successful transfusion of human blood to a patient for the treatment of postpartum hemorrhage. Using the patient's husband as a donor, he extracts approximately four ounces of blood from the husband's arm and, using a syringe, successfully transfuses the wife. Between 1825 and 1830, he performs 10 transfusions, five of which prove beneficial to his patients, and publishes these results. He also devises various instruments for performing transfusions and proposed rational indications.

1840 At St. George's School in London, Samuel Armstrong Lane, aided by consultant Dr. Blundell, performs the first successful whole blood transfusion to treat hemophilia.

1867 English surgeon Joseph Lister uses antiseptics to control infection during transfusions.

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.

1900 Karl Landsteiner, an Austrian physician, discovers the first three human blood groups, A, B and O. The fourth, AB, is added by his colleagues A. Decastello and A. Sturli in 1902. Landsteiner receives the Nobel Prize for Medicine for this discovery in 1930.

1907 Hektoen suggests that the safety of transfusion might be improved by crossmatching blood between donors and patients to exclude incompatible mixtures. Reuben Ottenberg performs the first blood transfusion using blood typing and crossmatching in New York. Ottenberg also observed the mendelian inheritance of blood groups and recognized the “universal” utility of group O donors.

1908 French surgeon Alexis Carrel devises a way to prevent clotting by sewing the vein of the recipient directly to the artery of the donor. This vein-to-vein or direct method, known as anastomosis, is practiced by a number of physicians, among them J.B. Murphy in Chicago and George Crile in Cleveland. The procedure, however, proves unfeasible for blood transfusions, but paves the way for successful organ transplantation, for which Carrel receives the Nobel Prize in 1912.

1908 Moreschi describes the antiglobulin reaction.

1912 Roger Lee, a visiting physician at the Massachusetts General Hospital, along with Paul Dudley White, develops the Lee-White clotting time. Adding another important discovery to the growing body of knowledge of transfusion medicine, Lee demonstrates that it is safe to give group O blood to patients of any blood group, and that blood from all groups can be given to group AB patients. The terms "universal donor" and "universal recipient" are coined.

1914 Long-term anticoagulants, among them sodium citrate, are developed, allowing longer preservation of blood.

1915 At Mt. Sinai Hospital in New York, Richard Lewisohn uses sodium citrate as an anticoagulant to transform the transfusion procedure from direct to indirect. In addition, R. Weil demonstrates the feasibility of refrigerated storage of such anticoagulated blood. Although this is a great advance in transfusion medicine, it takes 10 years for sodium citrate use to be accepted.

1916 Francis Rous and J.R. Turner introduce a citrate-glucose solution that permits storage of blood for several days after collection. Allowing for blood to be stored in containers for later transfusion aids the transition from the vein-to-vein method to direct transfusion. This discovery also allows for the establishment of the first blood depot by the British during World War I. Oswald Robertson is credited as the creator of the blood depots.

1927-1947 The MNSs and P systems are discovered.

1932 The first blood bank is established in a Leningrad hospital.

1937 Bernard Fantus, director of therapeutics at the Cook County Hospital in Chicago, establishes the first hospital blood bank. In creating a hospital laboratory that can preserve and store donor blood, Fantus originates the term "blood bank." Within a few years, hospital and community blood banks begin to be established across the United States. Some of the earliest are in San Francisco, New York, Miami and Cincinnati.

1939/40 The Rh blood group system is discovered by Karl Landsteiner, Alex Wiener, Philip Levine and R.E. Stetson and is soon recognized as the cause of the majority of transfusion reactions. Identification of the Rh factor takes its place next to ABO as one of the most important breakthroughs in the field of blood banking.

1940 Edwin Cohn, a professor of biological chemistry at Harvard Medical School, develops cold ethanol fractionation, the process of breaking down plasma into components and products. Albumin, a protein with powerful osmotic properties, plus gamma globulin and fibrinogen are isolated and become available for clinical use. The efficacy of albumin in transfusion is demonstrated by John Elliott.

1940 The United States government established a nationwide program for the collection of blood. Charles R. Drew develops the “Plasma for Britain” program. The American Red Cross participates, collecting 13 million units of blood by the end of World War II.

1941 Isodor Ravdin, a prominent surgeon from Philadelphia, effectively treats victims of the Pearl Harbor attack with Cohn's albumin for shock. Injected into the blood stream, albumin absorbs liquid from surrounding tissues, preventing blood vessels from collapsing and thus causing shock.

1943 The introduction by J.F. Loutit and Patrick L. Mollison of acid citrate dextrose (ACD) solution, which reduces the volume of anticoagulant, permits transfusions of greater volumes of blood and permits longer term storage.

1943 P. Beeson publishes the classic description of transfusion-transmitted hepatitis.

1945 Coombs, Mourant and Race describe the use of antihuman globulin (later known as the “Coombs Test”) to identify “incomplete” antibodies.

1950 Audrey Smith reports the use of glycerol cryoprotectant for freezing red blood cells.

1950 In one of the single most influential technical developments in blood banking, Carl Walter and W.P. Murphy, Jr., introduce the plastic bag for blood collection. Replacing breakable glass bottles with durable plastic bags allows for the evolution of a collection system capable of safe and easy preparation of multiple blood components from a single unit of whole blood. Development of the refrigerated centrifuge in 1953 further expedites blood component therapy.

1959 Max Perutz of Cambridge University deciphers the molecular structure of hemoglobin, the molecule that transports oxygen and gives red blood cells their color.

1961 The role of platelet concentrates in reducing mortality from hemorrhage in cancer patients is recognized.

1962 The first antihemophilic factor (AHF) concentrate to treat coagulation disorders in hemophilia patients is developed through fractionation.

1964 Plasmapheresis is introduced as a means of collecting plasma for fractionation.

1965 Judith G. Pool and Angela E. Shannon report a method for producing Cryoprecipitated AHF for treatment of hemophilia.

1967 Rh immune globulin is commercially introduced to prevent Rh disease in the newborns of Rh-negative women.

1969 S. Murphy and F. Gardner demonstrate the feasibility of storing platelets at room temperature, revolutionizing platelet transfusion therapy.

1972 Apheresis is used to extract one cellular component, returning the rest of the blood to the donor.

1979 A new anticoagulant preservative, CPDA-1, extends the shelf life of whole blood and red blood cells to 35 days, increasing the blood supply and facilitating resource sharing among blood banks.

Early 1980s With the growth of component therapy, products for coagulation disorders and plasma exchange for the treatment of autoimmune disorders, hospital and community blood banks enter the era of transfusion medicine, in which doctors trained specifically in blood transfusion actively participate in patient care.

1983 Additive solutions extend the shelf life of red blood cells to 42 days.