Analysis of Operation
The original opinion that the collection of blood and the separation of
plasma would be "as simple as mixing a cocktail" promptly proved
fallacious. The mass production of liquid plasma and its shipment abroad were
very different from the production of small quantities for immediate local use.
There were long debates on the size and shape of the collecting bottles, the
stopper, the collection of blood by vacuum versus suction versus simple venous
pressure, and the technique of removal of supernatant plasma. There were also
discussions about the criteria for donors. Eventually, the age range was set at
21 to 60 years inclusive, the systolic blood pressure at 110 mm. Hg, and the
hemoglobin level at 80 percent. Fasting was considered desirable, but the
requirement proved impractical.
To set up criteria for production, to develop standard techniques, and to
insure the safety of the final product involved far more difficulties than could
be solved by volunteer part-time workers, and Dr. Charles R. Drew, later Assistant Professor of Surgery, Howard University, was appointed full-time medical supervisor of the project shortly after it was initiated.
The New York experience with liquid plasma led to the later decision that
dried plasma would best solve the problem of so-called blood substitutes for the
Armed Forces because of its greater stability; the simplicity of its packing, storage,
and transportation; and reduced losses from breakage.
The Blood for Britain project was a most valuable introduction to the later
development of the American Red Cross Blood Donor Service. ... The
experience of the New York chapter served as a pattern for the organization and
operation of the blood donor service which was to supply plasma for the Armed
Forces and blood for oversea shipment. This chapter was ready to begin
operations as soon as the Surgeons General of the Army and the Navy requested
the American Red Cross to be responsible for the blood donor program.
There were many mistakes made in the operation of the blood and plasma
program during the United States participation in World War II, but far more
would have been made without the trial-and-error experience of the Blood for
Britain project. The chief lesson learned was that blood and plasma, if they are
to remain uncontaminated and safe for use, must be handled in a completely
closed system. ...
The British Blood Program In World War II
The Association of Voluntary Blood Donors founded in Great Britain in 1922 later
became the British Red Cross Transfusion Service, the first organization of its
kind in the world and the forerunner of a number of similar associations in
Great Britain and elsewhere (37). Blood banks were in operation in
various hospitals in that country for at least 6 years before the outbreak of
World War II.
In the months after the Munich crisis in 1938, recent advances in transfusion techniques, especially the use of stored blood on the field in the Spanish Civil War, were under constant discussion in Great Britain (32, 37, 38). The Medical Research Council, on behalf of the Ministry of Health, established four blood depots in the outer suburbs of London. Arrangements were also made to establish an Army Transfusion Service, which would enroll all available donors in the South-Western Countries and which would also supply civilian needs in that area. ...
The British blood program was a remarkably successful operation for ... two
reasons ...: (1) that it was carefully planned before hostilities
began, and (2) that it was based on the concept that blood is a perishable
fluid, as potentially dangerous as it is potentially useful, and therefore to be
handled in special channels by specially trained personnel. The daily, almost
hourly, care that trained British officers and men gave to the blood they
handled reduced accidents to a minimum. The British also regarded it as
essential that their armies be self-contained as regards blood. The success of
the attempt in World War II, first made by the British in the Western Desert, to bring surgeons forward to casualties, was due in large part to the successful operation of the Army Transfusion Service.
A similar separate service was recommended by the Subcommittee on Blood
Substitutes, NRC, for the U.S. Armed Forces early in U.S. participation in the
war. ... Such a service was later set up in Italy, and time, expense, and
lives would have been spared if it had been put into operation when it was
Functions of the Army Transfusion Service
The chief function of the British Army Transfusion Service was to supply
blood and other fluids, including crystalloid solutions, with equipment for
their use, to the entire British Army overseas and in the United Kingdom, and
also to supply civilian needs in the areas of the United Kingdom in which it
operated. Liquid plasma was used in temperate climates and was safely exported
as far as India; it was kept cool but not under refrigeration.
Dried human grouping serum was prepared by the Army Transfusion Service. It
was selected because it did not require refrigeration. It was colored with
acriflavine for group A and with methylene blue for group B. ...
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.)