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Blood History

The Impact of War

From the First to the Second World War, scientists and physicians inspired rapid progress in the large-scale storage and use of blood. War was not an incidental factor to these developments, as it created unprecedented demand for the life-saving fluid. Much as the Spanish Civil War was a prelude to World War II, so was blood first transported to the front lines of battle in Spain. By the time war had spread through Europe, the Allied forces were aided by a well-organized blood supply. Even prior to U.S. military involvement, two Americans -- Edwin Cohn and Dr. Charles Drew -- had revolutionized the storage and distribution of blood.

1922: Percy Lane Oliver begins operating a blood donor service out of his home in London. He recruits volunteers who agree to be on 24-hour call and to travel to local hospitals to give blood as the need arises. All volunteers are screened for disease, tested for blood type, and their names are entered into a phone log, so they can be quickly contacted when blood is required.

1930: On March 23, at the Sklifosovsky Institute in Moscow, Dr. Serge Yudin is the first to test the efficacy of transfusing humans with cadaver blood. He successfully resuscitates a young man who's slashed both his wrists attempting suicide by injecting him with 420 cc of blood from a cadaver of a 60-year-old man, who has died after being hit by an omnibus.

The Soviets are the first to establish a network of facilities to collect and store blood for use in transfusions at hospitals.

1935: A group of anesthesiologists at the Mayo Clinic in Rochester, MN, having organized a transfusion service two years earlier, are the first to begin storing citrated blood and utilizing it for transfusions within a hospital setting in the U.S.

1936: In August, physician Federico Duran-Jorda establishes the Barcelona Blood-Transfusion Service. The service collects blood, tests it, pools it by blood group, preserves and stores it in bottles under refrigeration, and by way of vehicles fitted with refrigerators, transports it to front line hospitals during the Spanish Civil War.

Canadian surgeon Dr. Norman Bethune, a volunteer with the leftist forces (Republican Army) in the Spanish Civil War, organizes a similar mobile blood service in Madrid -- The Spanish-Canadian Blood Transfusion Institute.

1937: Dr. Bernard Fantus coins the term "blood bank" to describe the blood donation, collection, and preservation facility he starts at Cook County Hospital in Chicago, IL, as Director of Therapeutics.

1939-40: In 1939, Drs. Philip Levine and R.E. Stetson uncover an unknown antibody in the blood of a woman who's given birth to a stillborn, and postulate that a factor in the blood of the fetus, inherited from the father, triggers the antibody production in the mother.

In 1940, Drs. Karl Landsteiner and Alex Wiener discover the Rh blood group, through experiments with the red blood cells of Rhesus monkeys, and identify the antibody found by Levine and Steston to be anti-Rh.

1940: A plasma shortage in Britain during World War II prompts the U.S. to organize the Plasma of Britain campaign, run by Dr. Charles Drew from a central laboratory at Presbyterian Hospital in New York. Building on techniques he's already developed to separate and preserve blood plasma, which he finds to be a viable substitute for whole blood, Dr. Drew devises a modern and highly sterile system to process, test, and store plasma for shipment overseas by the Red Cross.

Searching for a durable substitute for liquid plasma, Harvard biochemist Edwin Cohn invents a method to separate out its different proteins (or fractions). In a series of steps that are repeated, with slight variations in temperature and chemical conditions, plasma is mixed with the solvent ethyl alcohol and centrifuged. Through this process dubbed fractionation, Cohn and his team are able to isolate the plasma components fibrinogen (Fraction I), gamma globulin (Fraction II and III), and albumin (Fraction V). Each of these fractions are thought to contain different therapeutic properties, with albumin holding the most promise.

1941: In January, at the behest of the Surgeon General of the U.S. Army and Navy, the American Red Cross agrees to organize a civilian blood donor service to collect blood plasma for the war effort. The first center opens in New York on February 4, and the Red Cross collects over 13 million units of blood over the course of the war.

Philadelphia surgeon Dr. Isidor Ravdin successfully treats victims of the Pearl Harbor attack with albumin to increase blood volume.

1943: In his report in JAMA (the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION), Dr. Paul Beeson links the occurrence of jaundice in seven cases to blood or plasma transfusions the patients receive a few months prior, providing the quintessential description of tranfusion-transmitted hepatitis.

1947: As an alternative to the Red Cross blood centers being set up across the country in the postwar period, directors of independent, community blood banks join together to form a national network of blood banks called the American Association of Blood Banks. Their first meeting is held in Dallas in November.

1948: Dr. Carl W. Walter, a trained surgeon, develops a plastic bag for the collection of blood. Prior to this, glass bottles are used to store blood, but their fragility and susceptibility to contamination prompts him to devise a stronger and more portable container using plastic, which revolutionizes blood collection.