Wednesday, April 23, 2008

Highlights of Transfusion History

1628 : English physician William Harvey discovers the circulation of blood. Shortly afterward, the earliest known blood transfusion is attempted.

1665: The first recorded successful blood transfusion occurs in England: Physician Richard Lower keeps dogs alive by transfusion of blood from other dogs.

1667 : Jean-Baptiste Denis in France and Richard Lower in England separately report successful transfusions from lambs to humans. Within 10 years, transfusing the blood of animals to humans becomes prohibited by law because of reactions.

1795: In Philadelphia, American physician Philip Syng Physick, performs the first human blood transfusion, although he does not publish this information.

1818: James Blundell, a British obstetrician, performs the first successful transfusion of human blood to a patient for the treatment of postpartum hemorrhage. Using the patient's husband as a donor, he extracts approximately four ounces of blood from the husband's arm and, using a syringe, successfully transfuses the wife. Between 1825 and 1830, he performs 10 transfusions, five of which prove beneficial to his patients, and publishes these results. He also devises various instruments for performing transfusions and proposed rational indications.

1840: At St. George's School in London, Samuel Armstrong Lane, aided by consultant Dr. Blundell, performs the first successful whole blood transfusion to treat hemophilia.

1867: English surgeon Joseph Lister uses antiseptics to control infection during transfusions.

1873-1880: US physicians transfuse milk (from cows, goats, and humans).

1884: Saline infusion replaces milk as a “blood substitute” due to the increased frequency of adverse reactions to milk.

1900 : Karl Landsteiner, an Austrian physician, discovers the first three human blood groups, A, B, and C. Blood type C was later changed to O. His colleagues Alfred Decastello and Adriano Sturli add AB, the fourth type, in 1902. Landsteiner receives the Nobel Prize for Medicine for this discovery in 1930.

1907: Hektoen suggests that the safety of transfusion might be improved by crossmatching blood between donors and patients to exclude incompatible mixtures. Reuben Ottenberg performs the first blood transfusion using blood typing and crossmatching in New York. Ottenberg also observed the mendelian inheritance of blood groups and recognized the “universal” utility of group O donors.

1908: French surgeon Alexis Carrel devises a way to prevent clotting by sewing the vein of the recipient directly to the artery of the donor. This vein-to-vein or direct method, known as anastomosis, is practiced by a number of physicians, among them J.B. Murphy in Chicago and George Crile in Cleveland. The procedure proves unfeasible for blood transfusions, but paves the way for successful organ transplantation, for which Carrel receives the Nobel Prize in 1912.

1908: Moreschi describes the antiglobulin reaction. The antiglobulin is a direct way of visualizing an antigen-antibody reaction that has taken place but is not directly visible. The antigen and antibody react with each other, then, after washing to remove any unbound antibody, the antiglobulin reagent is added and binds between the antibody molecules that are stuck onto the antigen. This makes the complex big enough to see.

1912: Roger Lee, a visiting physician at the Massachusetts General Hospital, along with Paul Dudley White, develops the Lee-White clotting time. Adding another important discovery to the growing body of knowledge of transfusion medicine, Lee demonstrates that it is safe to give group O blood to patients of any blood group, and that blood from all groups can be given to group AB patients. The terms "universal donor" and "universal recipient" are coined.

1914: Long-term anticoagulants, among them sodium citrate, are developed, allowing longer preservation of blood.

1915: At Mt. Sinai Hospital in New York, Richard Lewisohn uses sodium citrate as an anticoagulant to transform the transfusion procedure from direct to indirect. In addition, Richard Weil demonstrates the feasibility of refrigerated storage of such anticoagulated blood. Although this is a great advance in transfusion medicine, it takes 10 years for sodium citrate use to be accepted.

1916: Francis Rous and J.R.Turner introduce a citrate-glucose solution that permits storage of blood for several days after collection. Allowing for blood to be stored in containers for later transfusion aids the transition from the vein-to-vein method to indirect transfusion. This discovery also allows for the establishment of the first blood depot by the British during World War I. Oswald Robertson, an American Army officer, is credited with creating the blood depots. Robertson received the AABB Landsteiner Award in 1958 as developer of the first blood bank.

1927-1947: The MNSs and P systems are discovered. MNSs and P are two more blood group antigen systems - just as ABO is one system and Rh is another.

1939/40: The Rh blood group system is discovered by Karl Landsteiner, Alex Wiener, Philip Levine, and R.E. Stetson and is soon recognized as the cause of the majority of transfusion reactions. Identification of the Rh factor takes its place next to the discovery of ABO as one of the most important breakthroughs in the field of blood banking.

1940: Edwin Cohn, a professor of biological chemistry at Harvard Medical School, develops cold ethanol fractionation, the process of breaking down plasma into components and products. Albumin, a protein with powerful osmotic properties, plus gamma globulin and fibrinogen are isolated and become available for clinical use. John Elliott develops the first blood container, a vacuum bottle extensively used by the Red Cross.

1941: Isodor Ravdin, a prominent surgeon from Philadelphia, effectively treats victims of the Pearl Harbor attack with Cohn's albumin for shock. Injected into the blood stream, albumin absorbs liquid from surrounding tissues, preventing blood vessels from collapsing, a finding associated with shock.

1943: The introduction by J.F. Loutit and Patrick L. Mollison of acid citrate dextrose (ACD) solution, which reduces the volume of anticoagulant, permits transfusions of greater volumes of blood and permits longer term storage.

1943: P. Beeson publishes the classic description of transfusion-transmitted hepatitis.

1945: Coombs, Mourant, and Race describe the use of antihuman globulin (later known as the “Coombs Test”) to identify “incomplete” antibodies.

1950 : Audrey Smith reports the use of glycerol cryoprotectant for freezing red blood cells.

1950: In one of the single most influential technical developments in blood banking, Carl Walter and W.P. Murphy, Jr., introduce the plastic bag for blood collection. Replacing breakable glass bottles with durable plastic bags allows for the evolution of a collection system capable of safe and easy preparation of multiple blood components from a single unit of whole blood. Development of the refrigerated centrifuge in 1953 further expedites blood component therapy.

Mid-1950s: In response to the heightened demand created by open-heart surgery and advances in trauma care patients, blood use enters its most explosive growth period.

1959: Max Perutz of Cambridge University deciphers the molecular structure of hemoglobin, the molecule that transports oxygen and gives red blood cells their color.

1960 : A. Solomon and J.L. Fahey report the first therapeutic plasmapheresis procedure - a procedure that separates whole blood into plasma and red blood cells.

1961: The role of platelet concentrates in reducing mortality from hemorrhage in cancer patients is recognized.

1962 : The first antihemophilic factor (AHF) concentrate to treat coagulation disorders in hemophilia patients is developed through fractionation.

1964 : Plasmapheresis is introduced as a means of collecting plasma for fractionation.

1965 : Judith G. Pool and Angela E. Shannon report a method for producing Cryoprecipitated AHF for treatment of hemophilia.

1967: Rh immune globulin is commercially introduced to prevent Rh disease in the newborns of Rh-negative women.

1969: S. Murphy and F. Gardner demonstrate the feasibility of storing Platelets at room temperature, revolutionizing platelet transfusion therapy.

1970: Blood banks move toward an all-volunteer blood donor system.

1971 : Hepatitis B surface antigen (HBsAg) testing of donated blood begins.

1972 : Apheresis is used to extract one cellular component, returning the rest of the blood to the donor.

1979 : A new anticoagulant preservative, CPDA-1, extends the shelf life of whole blood and red blood cells to 35 days, increasing the blood supply and facilitating resource sharing among blood banks.

Early 1980s: With the growth of component therapy, products for coagulation disorders, and plasma exchange for the treatment of autoimmune disorders, hospital and community blood banks enter the era of transfusion medicine, in which doctors trained specifically in blood transfusion actively participate in patient care.

1981: First Acquired Immune Deficiency Syndrome (AIDS) case reported.

1983: Additive solutions extend the shelf life of red blood cells to 42 days.

1984: Human Immunodeficiency Virus (HIV) identified as cause of AIDS

1985: The first blood-screening test to detect HIV is licensed and quickly implemented by blood banks to protect the blood supply.

1987 : Two tests that screen for indirect evidence of hepatitis are developed and implemented, hepatitis B core antibody (anti-HBc) and the alanine aminotransferase test (ALT).

1989 : Human-T-Lymphotropic-Virus-I-antibody (anti-HTLV-I) testing of donated blood begins.

1990: Introduction of first specific test for hepatitis C, the major cause of “non-A, non-B” hepatitis.

1992 : Testing of donor blood for HIV-1 and HIV-2 antibodies (anti-HIV-1 and anti-HIV-2) is implemented.

1996 : HIV p24 antigen testing of donated blood begins. Although the test does not completely close the HIV window, it shortens the window period.

2002 : West Nile virus identified as transfusion transmissible.

Facts About Blood Donation

The following information has been extracted from the Chiranjeevi Charitable Trust Website and compiled here.

Who needs blood?

The need for blood is great. Blood transfusions often are needed for trauma victims - due to accidents and burns - heart surgery, organ transplants, and patients receiving treatment for leukemia, cancer or other diseases, such as sickle cell disease and thalassemia. And with an aging population and advances in medical treatments and procedures requiring blood transfusions, the demand for blood continues to increase.

Who donates blood?

To be eligible to donate blood, a person must be in good health and generally must be at least 18 years of age (although in some cases younger people are permitted to donate blood, with parental consent.)

What are the criteria for blood donation?

Minimum weight requirements may vary among facilities, but generally, donors must weigh at least 45 kgs Most blood banks have no upper age limit. All donors must pass the physical and health history examinations given prior to donation.
The donor's body replenishes the fluid lost from donation in 24 hours. It may take up to two months to replace the lost red blood cells. Whole blood can be donated once every eight weeks (56 days).

Who should not donate blood?

Anyone who has ever used intravenous drugs (illegal IV drugs)
Anyone with a positive antibody test for HIV (AIDS virus)
Anyone who has had hepatitis
Anyone who has/has had cancer
Anyone who has risk factors for HBS Ag,HCV,VDRL,Maleria.

Where is blood donated?

Blood donations should be made only at licensed blood banks, Voluntary blood donation camps conducted by recognized organizations and at hospital-based donor centers.

What are the constituents of each unit of blood ?

Typically, each donated unit of blood, referred to as whole blood, is separated into multiple components, such as red blood cells, plasma, platelets, and cryoprecipitated AHF (antihemophilic factor). Presently CCT collects and provides whole blood only. However in the near future, CCT proposes to possess technology for a State of the Art Components Unit and provide blood components too. Each blood component can be transfused to a different individual, each with different needs.

What tests are performed on donated blood?

After blood has been drawn, it is tested for ABO group (blood type) and Rh type (positive or negative), as well as for any unexpected red blood cell antibodies that may cause problems in a recipient. Screening tests also are performed for evidence of donor infection with hepatitis B and C viruses, human immunodeficiency viruses HIV-1 and HIV-2, human T-lymphotropic viruses HTLV-I and HTLV-II, and syphilis.

The specific tests currently performed are listed below:
* Hepatitis B surface antigen (HBsAg)
* Hepatitis B core antibody (anti-HBc)
* Hepatitis C virus antibody (anti-HCV)
* HIV-1 and HIV-2 antibody (anti-HIV-1 and anti-HIV-2)
* Serologic test for syphilis

What kind of precautions are taken while collecting blood?

Besides conducting all relevant medical tests to ascertain the eligibility of individual donors’ , blood is collected in the utmost hygienic conditions using disposable blood bags, ,needles and syringes under the supervision of qualified lab technicians.

How is blood stored and used?

Each unit of whole blood normally is stored under refrigeration for a maximum of 42 days.

What fees are associated with blood?

While donated blood is free, there are significant costs associated with collecting, testing, preparing components, labeling, storing and shipping blood; recruiting and educating donors; and quality assurance. As a result, processing fees are charged to recover costs.

What is the availability of blood?

The blood supply level fluctuates throughout the year. For example, after the Kargil war or Gujarat earth quake blood supply swelled to very high levels, due to the overwhelming response of donors but otherwise is very scarce to obtain.

What can you do if you aren’t eligible to donate?

While a given individual may be unable to donate, he or she may be able to recruit a suitable donor. Blood banks are always in need of volunteers to assist at blood draws or to organize blood donation camps.

What is the most common blood type?

The approximate distribution of blood types in the population is as follows.

* O Rh-positive 38 Percent
* O Rh-negative 7 Percent
* A Rh-positive 34 Percent
* A Rh-negative 6 Percent
* B Rh-positive 9 Percent
* B Rh-negative 2 Percent
* AB Rh-positive 3 Percent
* AB Rh-negative 1 Percent

In an emergency, anyone can receive type O red blood cells, and type AB individuals can receive red blood cells of any ABO type. Therefore, people with type O blood are known as “universal donors,” and those with type AB blood are known as “universal recipients.” In addition, AB plasma donors can give to all blood types.

Tuesday, April 22, 2008

Components Of Blood

The below mentioned data is shared by Mr.Siva Prasad, who is working along with me in our company. I thank him for sharing this valuable information.

Where Blood is Created

Blood cells begin in the bone marrow, the soft, spongy material in the center of most large bones in the body. They begin as a hematopoietic cell, more commonly known as a "stem cell," and either mature in the marrow or travel to other parts of the body where they mature into functioning blood cells. The spleen, liver, and lymph nodes are also involved in the blood cell production process, medically known as hematopoiesis.


Blood is the vital liquid that circulates through the body. It is pumped by the heart through the arteries, veins, and capillaries. It carries nourishment, oxygen, heat, antibodies, hormones, vitamins, and electrolytes to every cell. It carries away from those same cells carbon dioxide (CO2) and other waste products to be disposed of via organs such as the lungs, liver, and kidney. Whole blood contains red blood cells, white blood cells, platelets, and plasma.

Red Blood Cells (RBCs)

Red blood cells, also called erythrocytes, contain a complex iron-containing protein called hemoglobin that gives blood its red color. In every two to three drops of blood there are around one billion red blood cells with an average life span of about 120 days. When there aren’t enough red blood cells in the system, the kidneys release erythropoietin, a hormone that alerts the bone marrow to make more. The average adult male has a hematocrit (percentage of blood volume composed of red blood cells) of about 47%.

White Blood Cells

White blood cells (WBCs) make up the body’s immune system and protect it from bacteria, viruses, and fungus. In the marrow, white blood cells outnumber the red by 2-1, but in the bloodstream the red blood cells outnumber the white by 600-1. There are five types of white blood cells; neutrophils, monocytes, lymphocytes, eosiniphils, and basophils.


Platelets come from special cells called megakaryoctyes. They are the smallest of the blood cells and make up 5%-7% of the blood volume. Platelets have a life span of 9-10 days and are then (like the red blood cells) removed from the body by the spleen. The platelets main function is to form clots to stop bleeding.


Plasma is the liquid portion of blood; a straw-colored, protein-salt solution that is 90% water. The other 10% is composed of inorganic electrolytes and blood proteins such as albumins, globulins, fibrinogens, and hemoglobin. They all contribute to the multiple functions that plasma performs, including maintaining blood pressure and supplying blood-clotting proteins; it is also the transport and storage for important minerals like potassium and sodium.

In order to preserve clotting factors, donated plasma is frozen within hours of donation and can be stored for 1-7 years. It is often used to treat bleeding disorders and used in a plasma replacement process called plasma exchange. Plasma is the most frequently paid-for component of blood and can be collected from a healthy donor up to two times a week.

Monday, April 21, 2008

Who Can Donate Blood

The below content is again taken from Firends2Support Website:

Let others benefit from your good health. Do donate blood if ...

* You are between age group of 18-60 years.
* Your weight is 45 kgs or more.
* Your hemoglobin is 12.5 gm% minimum.
* Your last blood donation was 3 months earlier.
* You are healthy and have not suffered from malaria, typhoid or other transmissible disease in the recent past.

There are many, many people who meet these parameters of health and fitness!
Do abide by our rules - be truthful about your health status!
You have to be healthy to give 'safe blood'

Do not donate blood if you have any of these conditions:

* Cold / fever in the past 1 week.
* Under treatment with antibiotics or any other medication.
* Cardiac problems, hypertension, epilepsy, diabetes (on insulin therapy), history of cancer,chronic kidney or liver disease, bleeding tendencies, venereal disease etc.
* Major surgery in the last 6 months.
* Vaccination in the last 24 hours.
* Had a miscarriage in the last 6 months or have been pregnant / lactating in the last one year.
* Had fainting attacks during last donation.
* Have regularly received treatment with blood products.
* Shared a needle to inject drugs/ have history of drug addiction.
* Had sexual relations with different partners or with a high risk individual.
* Been tested positive for antibodies to HIV.

Pregnancy And Menstrual Period:

* Females should not donate blood during pregnancy.
* They can donate after 6 weeks following a normal delivery and when they are not breast feeding.
* Females should not donate blood if they are having heavy menstrual flow or menstrual cramps.

Blood Donation Facts

I had taken the below information from Friends2Support Website and consolidated here.

There are four main blood types: A, B, AB and O.

The gift of blood is the gift of life. There is no substitute for human blood.

Every year our nation requires about 4 Crore units of blood, out of which only a meager 40 Lakh units of blood are available.

One blood donation can save as many as three lives. One unit of blood can be separated into several components, including red blood cells, plasma and platelets. Red blood cells carry oxygen to the body's organs and tissue. Plasma is a pale yellow mixture of water, salts and proteins, including solvable clotting factors; plasma is 90 percent water and constitutes 55 percent of blood volume. Platelets are small blood cells that initiate blood clotting, controlling bleeding.

Every three seconds, someone needs blood. Blood fights against infection and helps heal wounds, keeping you healthy. Anemic patients need blood transfusions to increase their iron levels. Cancer, transplant and trauma patients and patients undergoing open-heart surgery require platelet transfusions to survive. People who have been in car accidents and suffered massive blood loss can need transfusions of 50 units or more of red blood cells.

The average bone marrow transplant requires 120 units of platelets and about 20 units of red blood cells. Severe burn victims can need 20 units of platelets during their treatment. Children being treated for cancer, premature infants, and children having heart surgery need blood and platelets from donors of all types.

Apheresis (ay-fur-ee-sis) is a special kind of blood donation that allows a donor to give specific blood components, such as platelets. Platelets must be used within five days of collection, hence blood donations are especially needed around 3-day weekends. Red blood cells must be used within 42 days. Plasma can be frozen and used for up to a year.

Blood makes up about 7 percent of your body's weight, and the average adult has 10 pints of blood in his or her body. Since a pint is pound, you lose a pound every time you donate blood.

What Type Are You?

O+ 1 person in 3 O- 1 person in 15
A+ 1 person in 3 A- 1 person in 16
B+ 1 person in 12 B- 1 person in 67
AB+ 1 person in 29 AB- 1 person in 167

* Those belonging to the O- blood group are called universal blood donors. The red blood cells of a universal blood donor may be transfused to anyone regardless of their blood type.
* The plasma of those belonging to the AB blood group may be transfused to anyone regardless of blood type.

Examples Of Blood Use:
1. Automobile Accident - 50 units of blood
2. Heart Surgery - 6 units of blood / 6 units of platelets
3. Organ Transplant - 40 units of blood / 30 units of platelets
4. 20 bags of cryoprecipitate - 25 units of fresh frozen plasma
5. Bone Marrow Transplant - 120 units of platelets/ 20 units of blood
6. Burn Victims - 20 units of platelets

Blood Donation Websites

I read in a newspaper that there are couple of websites that help the people who desperately need blood and they can locate the donors by city wise and area wise in India.

Blood Donation Websites:

* Bharat Blood Bank
* Indian Blood Donors and
* Friends2Support.

While registering into these websites, we have to provide all our details exactly as it is as the people who would be contacting us would be in need of blood. Whenever we donate blood, we have to make sure we update these websites too.

Chiranjeevi Charitable Trust (CCT):

Meanwhile, Chiranjeevi, popular Telugu Cinema Hero launched his own Charitable Trust called as Chiranjeevi Charitable Trust to help the needy by providing them with blood and also eye donation. Chiranjeevi Charitable Trust operates Chiranjeevi Blood Bank and Chiranjeevi Eye Bank and motivates the general public through the charisma of Chiranjeevi to promote blood donations and eye donations.

Chiranjeevi Charitable Trust has been started with two most important objectives:

1. To effectively bridge the gap between the demand and supply of safe and screened blood in the society.
2. To bring down the rate of blindness and help the visually impaired in the society.

Besides these core focus areas, Chiranjeevi Charitable Trust has certain long term objectives too, they include:

* Provide Health Aid to the needy and the underprivileged.
* Establish and Maintain Blood banks, Eye Banks, Artificial limbs centers, research centers. Identifying various other areas where measures are required to provide better medical relief to a larger number of people quickly and effectively.
* Establish and Maintain Institutes for the treatment and rehabilitation and recreation of mentally and physically challenged children and adults.
* Provide Educational support to poor children, establishing educational centers, provide monetary aid to the deserving students through scholarships, stipends and so on.
* Establish and maintain Libraries for educational aid.
* Establish and maintain Old Age homes for the poor and sick.
* Establish and Maintain Hostels for destitute children.
* Establish and maintain Vocational training centers for the poor and destitute women and children
* To identify and carry out any other act that is necessary to realize the above objectives.

By going through the objectives of the trust, I started donating blood at CCT since the past 3-4 years - if no one contacts me through the blood donation websites.

Please register yourselves at the above mentioned websites and payback to the society.

Why I Started This Blog

I got this habit of donating blood on my birthday (14th March) since 1998, that's when I met my classmate, Mr. Bharadwaj while doing my MBA at Tirupati, Andhra Pradesh.
He's got this good habit of donating blood on his birthday and I lapped it up. I thank him for the same and pray God to provide him with good health.

Initially, I used to donate four times a year and slowly decreased to three times and now, it is two times and I will try to go back to three times. The reason for decreasing from three times to two times is the timing of my donation. I donate on March 14th and since Mahatma Gandhi is my idol, I donate blood on his birthday, which falls on October 2nd. We need to have atleast three months gap between each blood donation.

Since I donate blood regularly, I thought it would be good if I start off a blog on blood donation and try to bring others on board.

This is a very small service that Iam trying to give back to the society which gave me so much.

I would be happy if anyone want to share their experiences and information on blood donation. I would quote them and add another post in this blog.