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Blood in War

World War II Blood Programs

The following is excerpted from BLOOD PROGRAM IN WORLD WAR II by Douglas Blair Kendrick (pgs. 13-16, 21-22, and 24).

Chapter I: Historical Note

Blood for Britain

Origin of Program

Alexis CarrelThe project in New York City hospitals which came to be known as Blood for Britain (34, 35) originated in June 1940, when Dr. Alexis Carrel, who had recently returned from France, made known the great need there for plasma for the treatment of shock in battle casualties. The idea of shipping plasma to France and England was suggested to the president of the Blood Transfusion Association of New York, and a meeting to discuss the possibility was called for 12 June 1940. It was attended by the trustees of the association; its Board of Medical Control; Dr. Carrel; experts in the field representing the Army, the Navy, NRC (National Research Council), and Rockefeller Institute; and representatives of a number of large pharmaceutical and biological firms.

It was the sense of the meeting that, even though the use of plasma was still in an experimental stage, enough knowledge was available to justify an effort at quantity production. The cooperation of the New York chapter of the American Red Cross was secured as soon as it was pointed out to its officials that the experience to be gained from this project would be of great assistance in the National Defense Program, one phase of which was the supply of plasma for the Armed Forces. ...

The program became operational on 15 August 1940, at the Presbyterian Hospital in New York, and terminated on 17 January 1941. All the plasma collected went to Great Britain, France having fallen shortly after the 12 June meeting. The program, which represented the first effort in the United States to collect large amounts of blood from voluntary civilian donors for military use, had great popular appeal, and during its existence, 14,556 donations were made.

Technique of Collection and Shipment

Liquid plasma was selected for processing rather than dried plasma, partly because the time element was vital and partly because of the expense of installing drying equipment, whose performance at this time was still inadequate and far from satisfactory.

Originally, the system by which the blood was collected was not completely closed. Later, it was realized that a completely closed system was imperative.

The Tower of LondonThe plasma was separated by either sedimentation or centrifugation. To reduce viscosity, it was diluted with equal amounts of sterile physiologic salt solution; the solution, under 13 inches of water vacuum, was in the Baxter bottle (Plasmavac) in which it was finally dispensed. Merthiolate was added in quantity sufficient to guarantee dilution of 1:10,000 in the final plasma-saline mixture.

The finished product was shipped in 1,000-cc. bottles, six to a carton. Larger packages were not practical because the shipments were made by Clipper planes -- this was long before the existence of a transatlantic airlift.

Laboratory Tests and Losses from Contamination

Exacting bacteriologic and toxicity controls were required before any lot of plasma was dispensed. These tests were carried out not only in the laboratories of the participating hospitals but also in a central laboratory, under the direction of Dr. Frank L. Meleney. When the material reached England, samples from each carton were also checked bacteriologically before they were released for use. The latter precaution was instituted when it was found that certain pools of plasma that were free from bacteria when examined within 3 to 7 days after collection and processing were later found to be contaminated. Up to 1 November 1940, 1,950 liters of plasma were sent abroad as sterile after examination in Dr. Meleney's laboratory and 30 liters had been discarded because of contamination. The delayed contamination just described was discovered soon after this analysis had been made, and more rigid bacteriologic controls were at once set up. The total figures show that of 6,151 liters of plasma produced, 361 liters were found contaminated at the various hospitals and 160 liters were found contaminated in the central laboratory, the combined loss from contamination (exclusive of the amounts found contaminated in England) being 8.5 percent. The total loss from all causes was 581 liters, 9.4 percent; 151 bloods were rejected because of serologic evidence of syphilis (1.03 percent).

From BLOOD PROGRAM IN WORLD WAR II (SUPPLEMENTED BY EXPERIENCES IN THE KOREAN WAR) by Douglas Blair Kendrick. Washington, D.C.: Office of the Surgeon General, Department of the Army, 1989. (Provided by the Office of Medical History, Office of the Surgeon General/US Army Medical Command.)

Photo of Alexis Carrel: Courtesy of the National Library of Medicine.

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