The Evolution of Blood Transfusion: From WWI to Modern Day
In 'Health for Heroes' our History Committee explore the symbiotic relationship between the development of clinical and laboratory medicine and the experiences gained in conflicts around the world
The history of blood transfusion is a remarkable journey of scientific discovery and innovation, driven largely by the urgent needs of wartime medicine. From the early 20th century to the present day, key milestones in blood transfusion have saved countless lives and revolutionised medical practice.
Early Developments
Before the First World War, blood transfusion was a risky and often fatal procedure due to the lack of knowledge about blood compatibility and coagulation. The discovery of the ABO blood groups by Karl Landsteiner in 1901 was a pivotal breakthrough, allowing for safer transfusions by matching donor and recipient blood types.
World War I: A New Era for Blood Transfusion
The outbreak of World War I brought a dramatic increase in the need for effective blood transfusion techniques. In 1914, Belgian doctor Albert Hustin demonstrated that sodium citrate could prevent blood from clotting, enabling indirect transfusion. This method was quickly adopted by Luis Agote in Argentina and Richard Lewisohn in the United States, who confirmed its effectiveness.
During the war, Canadian doctor Lawrence Bruce Robertson pioneered the use of direct transfusion techniques on the battlefield. He developed a syringe-cannula system that allowed blood to be transferred directly from donor to patient, saving many lives.
In 1917, Captain Oswald H. Robertson of the U.S. Army Medical Corps established the first blood bank in France, using citrate-glucose solution to store blood. This innovation ensured a ready supply of blood for wounded soldiers, marking a significant advancement in medical logistics.
Interwar Innovations
The Spanish Civil War (1936-1939) saw further advancements in blood transfusion. Canadian physician Norman Bethune introduced mobile blood-transfusion units, bringing blood donation facilities closer to the front lines. His work demonstrated the importance of rapid response and accessibility in saving lives during conflict.
World War II: Mass Production and Standardisation
As World War II loomed, the need for a reliable blood transfusion service became critical. In 1938, the British War Office established the Army Blood Transfusion Service (ABTS), with Colonel L.E.H. Whitby at the helm. The ABTS organised blood collection, storage, and distribution on an unprecedented scale, producing both wet and dried plasma products.
The development of freeze-dried plasma by the Lister Institute in the UK and the introduction of Acid Citrate Dextrose (ACD) solution by J.F. Loutit and Patrick L. Mollison in 1943 allowed for longer storage and greater volumes of transfused blood. These advancements proved vital in treating military and civilian casualties during the war.
In the United States, Dr Charles R. Drew played a crucial role in the "Blood for Britain" program, which collected and shipped plasma to treat those injured during the Blitz. Drew's innovations in blood preservation and the use of bloodmobiles revolutionised blood donation and storage, making it more efficient and widespread.
Post-War Advances and Modern Techniques
The successes of wartime blood transfusion laid the groundwork for modern transfusion medicine. The establishment of the National Blood Transfusion Service in the UK and similar organisations worldwide ensured the continuous development and improvement of blood transfusion practices.
Modern techniques include the use of glycerolised frozen red blood cells, which can be stored for up to 10 years, and the introduction of apheresis technology, allowing for the collection of specific blood components. These advancements have enhanced the safety, efficiency, and availability of blood products.
Conclusion
The evolution of blood transfusion from the early 20th century to the present day is a testament to the power of scientific innovation and collaboration. The urgent demands of wartime medicine drove critical advancements that have saved countless lives and transformed medical practice. Today, the legacy of these pioneering efforts continues to benefit patients worldwide, underscoring the enduring importance of research and innovation in healthcare.
To learn more about the fascinating history of blood transfusion and its impact on medical practice, read the IBMS History Committee’s: HEALTH FOR HEROES: A BRIEF HISTORY.