Thirteen/WNET PBS

Blood History

New Challenges

After World War II, the science of blood reached new heights -- and setbacks. The invention of the plastic blood-collection bag reduced the external contamination of donated blood to unprecedented levels; the commercial introduction of Rh immunoglobin saved the lives of many Rh-positive babies born to Rh-negative mothers; and the development of Factor VIII concentrate offered hemophiliacs a new lease on life. Yet these improvements were soon overshadowed by contaminated blood supplies. Hepatitis and, more drastically and fatally, the HIV virus were transmitted to many transfusion recipients and hemophiliacs -- the very people who had come to rely on the blood of others. As a result of new policies responding to this tragedy, blood supplies are now safer than ever before.

1959: Through the use of X-ray crystallography, in which X-rays are beamed on crystals to reveal the distribution of their atoms, Dr. Max Perutz working at Cambridge University, England, is able to unravel the structure of hemoglobin, the protein within red blood cells that carries oxygen.

1965: Dr. Judith Pool, an American physiologist at Stanford University, discovers that slowly thawed frozen plasma yields deposits high in Factor VIII (or Antihemophilic Factor). The deposits called cryoprecipitates (or cryo) are found to have much greater clotting power than plasma and given to hemophiliacs to stop bleeding episodes. It prevents the need for hemophiliacs to travel to the hospital to be treated, since cyro can be kept frozen at home and infused, after being thawed, by a physician.

late-1960s: Drs. Kenneth M. Brinkhous of the University of North Carolina at Chapel Hill and Edward Shanbrom of Hyland Laboratories produce a highly concentrated form of Factor VIII by pooling large quantities of plasma that generate vast amounts of cyro, which are then redissolved, treated, filtered, and centrifuged. The resulting powder's clotting power is 100 times stronger than raw plasma, easily stored in a portable vial, and can be injected with a syringe by the hemophilia patient.

1971: In July, the Secretary of Health, Education, and Welfare Elliot Richardson transfers the responsibility of regulating the blood banking industry from the Division of Biologics Standards (DBS) to the Food and Drug Administration (FDA).

Dr. Baruch Blumberg of the National Institutes of Health (NIH) identifies a substance on the surface of the hepatitis B virus that triggers the production of antibodies. His work leads to the development of a test to detect the presence of hepatitis B antibodies, thereby identifying infected donors; the test is mandated by the FDA.

1981: The first cases of a syndrome initially called GRID (Gay-related Immunodeficiency Disease), due to its prevalence among gay men, are reported. It is later renamed AIDS (Acquired Immune Deficiency Syndrome).

1982: When hemophiliacs also begin to develop GRID, Dr. Bruce Evatt, a specialist in hemophilia at the Centers for Disease Control and Prevention (CDC), begins to suspect that the syndrome may be blood borne and presents his theories at a meeting of a group of the U.S. Public Health Service in July.

1983: Researchers at Dr. Luc Montagnier's lab at the Institut Pasteur, in France, isolate the virus that causes AIDS. They locate it in the swollen lymph node in the neck of a Parisian AIDS patient and label it LAV (lymphadenopathy-associated virus).

1984: Dr. Robert Gallo of the NIH announces that he's identified the virus that causes AIDS, which he calls HTLV III (human T-cell lymphotropic virus), at a press conference on April 23.

1985: After dozens of Americans are infected with AIDS from blood transfusions, the first blood-screening test to detect the presence or absence of HIV antibodies -- the ELISA test -- is licensed by the U.S. government on March 2. The test is universally adopted by American blood banks and plasma centers.

A legal battle ensues over who deserves credit for the discovery of the AIDS virus, which finally ends in 1987 when the U.S. and French governments agree to share credit and royalties from the sales of test kits for the virus.

1987-2002: A series of more sensitive tests are developed and implemented to screen donated blood for infectious diseases: two tests that screen for indirect evidence of hepatitis; the Human T-Lymphotropic-Virus-I-antibody (anti-HTLV-I) test; the hepatitis C test; the HIV-1 and HIV-2 antibodies test; the HIV p24 antigen test; and Nucleic Acid Amplification Testing (NAT) that directly detects the genetic material of viruses like HCV and HIV.