Ren Lei, Strategic Support Force Special Medical Center (formerly 306 Hospital), Department of Blood Transfusion
Edited by Liu Yan/Cui Yan, Medical Science Popularization Center, Ministry of Medical Research
In today's society, blood transfusion has become a very common clinical treatment, and blood transfusion medicine has gradually developed into an indispensable part of modern medicine, and thousands of patients rely on blood transfusion technology to obtain regeneration opportunities every year. However, like the history of the development of all other sciences and technologies, blood transfusion technology has also gone through many detours in the process of scientific rational use from its birth to the current scientific rational application, and many ironic stories have occurred during the period. Today we will review the history of blood transfusion.
Blood is also known as the river of life, and the stories and legends about blood can be traced back to prehistoric times, when the primitive ancestors of humans still lived in caves and lived by hunting. They did not understand what blood was, but they saw that blood flowed from the wounds of their prey and even their own bodies, and life gradually exhausted with the outflow of blood, and the magnitude of life and death made the red blood covered with a layer of mystery and magic, using blood as an object of worship or a symbol of sacrifice. In many cultures, blood is believed not only to carry life and vitality, but also to determine the character and destiny of individuals.
It is now unknown who tried a blood transfusion for the first time in human history. However, according to some sporadic historical records, the earliest attempts at therapeutic blood transfusion may have occurred in 1492, when Pope Innocent VIII fell seriously ill and fell into a coma, and in order to save the pope who had set off a wave of mass persecution of witches in Europe, doctors recommended blood transfusions for him in a vain attempt to gain the youthful power of the teenagers. Three 10-year-old boys became the first "blood donors.". Lacking knowledge of the anatomy of the circulatory system, doctors had to inject blood into the Pope's body through the mouth. Of course, this was not a real blood transfusion, and the end result was tragic, the boys died, and the pope's life was not saved. The infamous pope also became the first footnote in the history of blood transfusions.
In 1616, the great physiologist William Harvey proposed the theory of blood circulation: "The power of the continuous flow of blood comes from the systolic pressure of the myocardium; the pulse is produced, which is expanded due to blood vessel congestion; there is no invisible passage between the two ventricles; and the blood of the human body flows through the heart through the whole body and lungs." "What seems like common sense now was an absolutely epoch-making description at the time. Harvey's theory was not only an important part of the history of blood transfusions, but also a major step forward in seventeenth-century science.
In 1665, Richard Rolle, a physician in Oxford, England, completed the first inter-animal blood transfusion test. Richard draws part of the blood from one puppy, leaving it in a dying state, and then injects the blood of another large dog into the puppy by placing a transfusion vessel. Later, the puppy came back to life. However, this successful blood transfusion experiment did not attract people's attention at the time. Two years later, in 1667, Rolle connected the carotid artery of the sheep with the human humerus artery with a special tube, transfused the blood of the sheep to the person, and succeeded. In the same year, French doctor Dennis successfully replicated Rohr's human sheep transfusion experiment. The reasons for the success of this dangerous operation are unknown to us, but after the subsequent trial of various ways of injecting animal blood into the human body due to the violent transfusion reaction, which caused many deaths, in 1678 the Paris Medical Association banned blood transfusion. Nevertheless, these attempts have opened a new door to the cause of medicine.
Fast forward to the early nineteenth century, when many pregnant women died of excessive blood loss during childbirth. Obstetrician James Blundell, who could not bear the death of his patients from postpartum haemorrhage, after learning about the transfusion tests of his predecessors, believed that the early transfusion accidents were most likely due to the transfusion of "animal blood" and should not be transfused between different species, because they were far apart from each other. Later, he first injected more than 400 milliliters of blood intravenously into a dying stomach cancer patient. After the blood transfusion, the patient feels much better. Although the patient died two days later, this convinced Brendel that a blood transfusion method was feasible. In 1828, he transfused a pregnant woman who was bleeding after childbirth, using her husband as a blood donor, connecting the arteries in her husband's arm with the veins in her wife's arm, pulling the woman back from the line of death. In the years that followed, he transfused 10 dying patients and managed to snatch 4 people back from death. These clinical experiences were soon reported by The Lancet and received widespread attention, and under The Leadership of Blundell, a large number of blood transfusion practice institutions were established, including the famous Royal Hospital of Edinburgh, which will later become the lead institution for the standardization of blood transfusion technology in Europe, and will also be the location of the world's first "blood bank" in the modern sense.
In the 20th century, blood transfusion operations made progress at the theoretical level. At the heart of this advance is the discovery of blood types. In 1900, the Austrian physician Karl Landsteiner discovered three blood types: A, B, and O. Two years later, two of his students discovered AB blood. Since then, he has discovered mn blood type, P blood type and Rh blood type, and has been praised by posterity as the "father of blood type". Landsteiner's research found the main reason for previous blood transfusion failures and provided theoretical guidance for safe blood transfusions. He was also awarded the 1930 Nobel Prize in Physiology, and his birthday, 14 June, was designated as World Blood Donor Day.
In 1918, James Graham discovered the anticoagulant sodium citrate, which made a significant contribution to the storage of donated blood. Modern improved anticoagulants, such as glucose citrate, glucose citrate phosphate, and citrate, developed from these early anticoagulants. Without these substances, donated blood quickly stratifies, coagulates, and turns into bags of blood tofu. The discovery and use of these anticoagulants has become an important breakthrough in the history of blood transfusion.
In 1963, American physician Baruch Bloomberg discovered an antigenic substance in the blood of Australian Aborigines and named it Aa (Australian Antigen). Later he discovered the inextricable link between Aa and hepatitis. After research, Baruch and his colleagues made it clear that Aa is actually the surface antigen of the hepatitis B virus. In the United States in the 1960s, a significant proportion of patients who needed blood transfusion developed hepatitis. Doctors realized that if blood screening could be done appropriately, the incidence of post-transfusion hepatitis could be greatly reduced. As a result, in 1972, U.S. law officially stipulated that every blood sample should be tested for hepatitis B virus, and the blood would undergo strict quality checks before use, and the initial screening test for blood donation gradually developed. Since then, the safety of blood has been taken to a new height.
With the continuous development of modern science and technology and blood transfusion medicine, blood transfusion technology has become more and more mature, and blood transfusion has developed from whole blood to a wide variety of component transfusions. While enjoying the safety of blood transfusion, we should also keep in mind those predecessors who have tried continuously for the development of blood transfusion, and it is precisely because of their perseverance and courage to explore that we have modern blood transfusion medicine.
(Pictured from the Internet)