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Blood in War

World War II Blood Programs

(continued)

The Soviet Union Blood Program In World War II

While not a great deal is known about replacement therapy in the Soviet Union Moscow's Red Squareduring World War II, all reports indicate that blood was the chief replacement fluid (41-43). This might be expected because of the large civilian population; its proximity to the frontlines; the cold climate, which eliminated many of the difficulties of preservation and storage; and, perhaps, the lack of facilities for processing blood to plasma or serum. ...

The nationwide transfusion service that existed in the Soviet Union before the war was organized in Moscow in 1926, by Lt. Col. Andre Arkadievich Bagdasarov. This officer later directed transfusions under fire during the border warfare with the Japanese in 1939 and during the war with Finland in 1940-41.

The Central Institute for Blood Transfusion in Moscow was at the head of several subordinate institutes and about 1,500 blood donor centers. When Russia entered World War II, this organization became, in effect, a system of factories for collecting and preserving blood and delivering it to the front as it was needed.

About 2,000 persons a day gave blood in Moscow, about the same number who donated at the two blood centers in New York. All possible methods of "sanitary" propaganda were used to attract donors. About 95 percent of the donors were women, as compared with 50 percent in the United States. Donations ranged from 225 to 450 cc. A second donation was permitted in 4 to 6 weeks, but only if the blood picture had returned to normal. With these precautions, some donors had given blood for periods of 12 to 15 years with no ill effects.

A standard four-cornered container was used to collect and administer blood. The bottles were transported, preferably by plane, in specially constructed isothermic boxes, suitable for use in both warm and cold weather. Blood was also put up in 200-cc. ampules which could be carried by medical corpsmen and used well forward.

The Russians used type O blood for most battlefield transfusions and also used large amounts of type-specific, unpooled plasma. The institute worked out a method which permitted the preservation of blood for 3 or 4 weeks without loss of its biologic properties and also devised a technique for drying plasma that insured its solubility without turbidity or precipitation.

Transfusions were given at all points up to the regimental medical aid station (battalion aid station) but were most widely used at the medical sanitary battalion service level (collecting station). The most important indication was hemorrhage with shock, especially in wounds of the abdomen and extremities. The combined experience of the institute and the army was that only large transfusions, from 1,000 to 1,500 cc., given rapidly, were effective in shock. ...

Other Sources of Blood

Cadaveric blood. -- In 1928, Shamov reported the experimental use of cadaveric blood and demonstrated the absence of toxicity (48, 49). At this time, Yudin was in charge of the entire surgical and accident department of the Sklifosovsky Institute, the central hospital for emergency surgery in Moscow, in which from 8,000 to 10,000 patients were treated every year. The admissions also included many patients who died promptly from acute cardiac disease or severe trauma. In other words, the patients who needed transfusion and the bodies from which, in the light of Shamov's demonstration, the necessary blood could be secured, were both at hand.

Video Clip. Yudin reported his first seven transfusions with cadaveric blood at the Fourth Congress of Ukranian Surgeons at Kharkov in September 1930. The work was investigated by two commissions, one legal and the other military, both of which recognized its scientific foundation, and he was given a special permit to collect blood from fresh cadavers before autopsy.

With the discovery that cadaveric blood could be stored safely, time was provided for both serologic tests and bacteriologic examinations. In November 1932, Yudin reported to the Société Nationale de Chirurgie in Paris on 100 transfusions with cadaveric blood kept for 3 weeks, and in one instance 4 weeks. In 1937, he reported in the Lancet that he had performed a thousand transfusions by this method, chiefly for internal hemorrhage and traumatic shock and in operations for gastrointestinal disease, particularly cancer.

In Yudin's first 200 transfusions, all performed with citrated blood, there were 40 reactions, all moderate. In the next 800 transfusions, all performed with noncitrated blood, the incidence of reactions fell to 5 percent. The five fatal cases in the series were explained in three instances by technical errors, including the transfusion of incompatible blood. The fourth death was due to embolism and the remaining death to anaerobic infection.

Cadaveric blood was apparently never used widely, even in Russia. It was not mentioned to Dr. George K. Strode (42) of the Rockefeller Foundation, who visited the Central Blood Transfusion Institute of Moscow in October 1941, and no statement in the literature suggests that it was used during the war. It is doubtful that transfusions with blood secured from cadavers could ever have been employed in any country in the world except Russia, for the idea, in spite of its logic, is revolting.

Selected References

32. Conference on Shock and Transfusion, 25 May 1945.

34. REPORT OF THE BLOOD TRANSFUSION ASSOCIATION CONCERNING THE PROJECT FOR SUPPLYING BLOOD PLASMA TO ENGLAND, WHICH HAS BEEN CARRIED ON JOINTLY WITH THE AMERICAN RED CROSS FROM AUGUST, 1940, TO JANUARY, 1941. Narrative Account of Work and Medical Report. New York: Blood Transfusion Association, 31 Jan. 1941.

35. Stetten, D.: "The Blood Plasma for Great Britain Project." BULL. NEW YORK ACAD. MED. 17: 27-38, January 1941.

37. Proger, L. W.: "Development of the Emergency Blood Transfusion Scheme." BRIT. M. J. 2: 252-253, 29 Aug. 1942.

38. Whitby, L. E. H.: "The British Army Blood Transfusion Service." J.A.M.A. 124:421-424, 12 Feb. 1944.

41. Phalen, J. A.: THE BLOOD PLASMA PROGRAM. Division of Medical Sciences, NRC, Washington: Office of Medical Information, 25 July 1944.

42. Strode, G. K.: BLOOD TRANSFUSION AND DONORSHIP IN THE U.S.S.R. New York: Rockefeller Foundation, 14 Nov. 1941.

43. BLOOD PROCUREMENT PROGRAMS IN OTHER COUNTRIES. Distribution 74427, American Red Cross Blood Donor Service.

48. Yudin, S. S.: "Transfusion of Stored Cadaver Blood. Practical Considerations: The First One Thousand Cases." LANCET 2: 361-366, 14 Aug. 1937.

49. "Minutes, meeting of Subcommittee on Blood Substitutes, Division of Medical Sciences," NRC, 24 Feb. 1943.


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.)




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World War I and the Spanish Civil War

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Post-War Blood Systems




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