*

IMMUNOHEMATOLOGY
Chalee R. Sienes-Reyes, RMT, MSMT Medical Laboratory Science Department San Pedro College, Davao City

 Mysterious fascination Traditional : Living force Ancient Egyptians :bathed to resuscitate the sick and rejuvenate the incapacitated Ancient Rome : Aristocrats drank to rejuvenate and disease treatment Author / Playwrights : used as themes Modern man : transfuses it

1492-- First Transfusion : Pope Innocent VII but died

1615 - Andreas Libavius described his technique of Blood transfusion. It was unfortunately not adequately publicized.
1628 - English physician William Harvey (1578-1657) described the functions of the heart and the circulation of Blood.

1665 - The first Blood transfusions of record take place. Animal experiments conducted by Richard Lower, an Oxford physician started as dog-to-dog experiments and proceeded to animal-to-human over the next two years. Dogs were kept alive by the transfusion of Blood from other dogs.

1667 - Jean-Baptiste Denis in France reported successful transfusions from sheep to humans.
1678 - Transfusion from animals to humans, having been tried in many different ways, was deemed to be unsuccessful, and was subsequently outlawed by the Paris Society of Physicians because of reactions, many resulting in death.

1667 - JEAN DENIS : physician to Louis XIV transfused a small amount of blood from young lamb to a young man

http://www.dailymail.co.uk/sciencetech/article-1232001/Blood-transfusions-black-holes-Royal-Society-publishes350-years-scientific-discoveries-online.html

L---- http://www.newscientist.com/blogs/culturelab/2011/03/21/PG204.jpg R --- http://www.wondersandmarvels.com/wp-content/uploads/2011/03/transfusion-JPEG.jpg

1665 direct blood transfusion in dogs by RICHARD LOWER from vein to artery (silver cannulate)

1785 Dr. Philip Syng : a physician from Philadelphia 1818 - James Blundell : an English Obstetrician, combat fetal hemorrhage

1840 - In London England, Samuel Armstrong Lane, aided by consultant Dr. Blundell, performed the first successful whole Blood transfusion to treat hemophilia.

1867 - English surgeon Joseph Lister utilized antiseptics to control infection during Blood transfusions.

TOP LEFT: http://www.healio.com/Hematology-Oncology/news/print/hematology-oncology/James-Blundellpioneer-of-blood-transfusion TOP CENTER & BOTTOM LEFT: http://kelty.org/or/classes/375/lectures/dracula0414.html RIGHT: http://www.sciencemuseum.org.uk/broughttolife/objects/display.aspx?id=91993

Instrument designed by Gesellius for obtaining capillary blood from donors

1873, IBM, Princetown, NJ:Haemonetics Corp, ,Natick, Mass,Fenwal Labs

Problem :

CLOTTING OF BLOOD

1869 BRAXTON HICKS recommended sodium phosphate

1873 to 1880 - Physicians in the United States are documented, during these years, to have transfused milk (from cows and goats)to humans.

1884 - Saline infusion replaced milk as a 'Blood substitute' due to increased frequency of adverse reaction to milk

1901 KARL LANDSTEINER discovered the ABO blood groups and explain serious reactions to incompatible transfusion
1902 - A fourth main Blood type, AB was found by A. Decastrello and A. Sturli.

1907 - Hektoen suggested that the safety of transfusion might be improved by crossmatching Blood between donors and patients to exclude incompatible mixtures. Reuben Ottenberg performed the first Blood transfusion using Blood typing and cross-matching. Ottenberg also observed the 'Mendelian inheritance' of Blood groups and recognized the universal utility of group O donors.

1908 - French surgeon Alexis Carrel devised a way to prevent Blood clotting. His method involved joining an artery in the donor, directly to a vein in the recipient with surgical sutures. He first used this technique to save the life of the son of a friend, using the father as donor. This procedure, not feasible for Blood transfusion, paved the way for successful organ transplantation, for which Carrel received the Nobel Prize in 1912

1912 - Roger Lee, a Massachusetts General Hospital visiting physician, along with P. D. White, formulated and developed the 'Lee-White' clotting time. Lee further demonstrated that Blood from all groups can be given to group AB patients.

1914 - Long-term anticoagulants, among them sodium citrate, were developed, allowing longer preservation of Blood.

1915 - At Mt. Sinai Hospital in New York City, Richard Lewisohn was documented to have used sodium citrate as an anticoagulant which was to, in the future, transform transfusion procedure from one that had to be performed with both the donor and the receiver of the transfusion in the same place at the same time,

EDWARD LINDERMANN 1 st to succeed vein to vein transfusion UNGER designed syringe value apparatus
1914 HUSTIN sodium citrate and glucose as a diluent and anticoagulant solution for transfusion 1915 - RICHARD LEWISOHN determine the minimum amount of anticoagulant and demonstration of non-toxicity on small amount of Sodium Citrate 1916 FRANCES PEYTON ROUS and JR TURNER introduce citrate dextrose solution for blood preservation note: established in Britain during WWI

RICHARD WEIL - demonstrate the feasibility of refrigerated storage of anticoagulated blood

LEFT: http://zygoma.tumblr.com/post/13127982008/the-first-practical-transfusion-method-the RIGHT: http://www.freepatentsonline.com/6537246.html

Oswald Robertson was credited as the creator of the Blood depots.

1925 - Karl Landsteiner, then working in New York City, in collaboration with Phillip Levine, discovered three more Blood groups: M, N and P.

1926 - The British Red Cross instituted the first human Blood transfusion service in the world.

1930 - Karl Landsteiner, the most important figure in transfusion medicine, who discovered the first three human Blood groups, received the Nobel Prize for Medicine.

1932 - The first facility functioning as a Blood bank was established in a Leningrad Russia hospital.

1937 - Bernard Fantus, director of therapeutics at the Cook County Hospital in Chicago, Illi nois (U. S.), established the first hospital Blood bank in the United States.

http://www.mmc.tn.gov.in/Department/blood%20bank/history%20of%20tranfusion.html

LEFT: http://greatexperimentsblog.blogspot.com/2011/11/first-human-marker-locus.html RIGHT: http://www.mmc.tn.gov.in/Department/blood%20bank/history%20of%20tranfusion.html

WWII increase demand of blood and plasma CHARLES R. DREW develop improve technique for blood storage and preservation - develop large scale Blood Bank in WWII Feb. 1941 - appointed as director of American Red Cross Blood Bank at Presbyterian Hospital
1943 J.F. LOUTIT and PATRICK L. MOLLISON of ENGLAND introduced ACD (acid Citrate Dextrose) 1947 blood banks were built

During the WAR

> Oswald Robertson Medical Reserve and Army officer estab. BB > Univ. of Luoisville create BB > Mid 1930's - Soviet Union set up 60 large blood centers and more than 500 subsidiary ones storing canned blood and shipping it to all corners of the country. > 1937 Bernard Fantus, director of therapuetics at the Cork Country Hosp. In Chicago estab. 1st Hosp. BB in the US > 1939 - Philip Levine and R.E. Stetson discovered Rh system > 1940 - Willem Johon Kolff organized the 1st BB in Europe

* WW I Blood Transfusion
Apparatus

TOP LEFT: http://cmclarkana.blogspot.com/2010/09/blood-transfusion-introduction-blood.html TOP RIGHT: http://westernciv2.umwblogs.org/2010/12/03/wwi-blood-transfusion/ BOTTOM LEFT: http://www.redcross.org.uk/About-us/Who-we-are/Museum-and-archives/Historical-factsheets/Blood-transfusion BOTTOM LEFTMOST: http://www.ssvms.org/museum/virtual_tour/Slide34Case10.html

1940 - Edwin Cohn, a professor of biological chemistry at Harvard Medical School, developed a 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 were isolated and became available for clinical use. The efficacy of the use of albumin in transfusion was then first demonstrated by John Elliott.

1941 - Isodor Ravdin, a prominent surgeon from Philadelphia, effectively treated 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; the finding associated with shock.
1943 - The introduction by J.F. Loutit and P. L. Mollison of acid citrate dextrose (ACD) solution, which reduces the volume of anticoagulant, permitted transfusions of greater volumes of Blood and longer term Blood storage.

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

Massive blood transfusion

Problem

Cardiac Overload

Solution

COMPONENT THERAPY

For continuous flow processing of blood components

Haemonetics machine

1873, IBM, Princetown, NJ:Haemonetics Corp, ,Natick, Mass,Fenwal Labs

Fenwal Blood processors connected in-line with donor's blood flow

1873, IBM, Princetown, NJ:Haemonetics Corp, ,Natick, Mass,Fenwal Labs

1945 - Coombs, Mourant and Race described the use of antihuman globulin (the Coombs T est) to identify incomplete antibodies.

1947 - The American Association of Blood Banks (AABB) was formed to "promote common goals among Blood banking facilities and the American Blood donating public."

1949 and 1950 - The U. S. Blood collection system had now grown to approximately 1,500 hospital Blood banks, 46 community Blood centers and 31 American Red Cross regional Blood centers.

1950 - The use of glycerol cryoprotectant for freezing red Blood cells became widespread.

1950 - Carl Walter and W. P. Murphy, Jr., introduced the plastic bag for Blood collection. This replaced breakable glass bottles with rugged plastic bags.

1951 - The AABB (American Association of Blood Banks) was established as a clearinghouse providing a centralized system in the United States for exchanging Blood among Blood banks.

1953 - Development of the refrigerated centrifuge began to further expedite Blood component therapy.

1954 - The Blood product Cryoprecipitate (now AHF) was developed for people suffering from hemophilia.

1954 to 1958 - Products made from Blood plasma were developed to treat diseases such as chicken pox.

1957 GIBSON introduced CPD (Citrate Phosphate Dextrose) was less acidic than ACD

1959 - Max Perutz of Cambridge Uni versity deciphered the molecular structure of hemoglobin, the molecule that transports oxygen and gives red Blood cells their color.

1960 - A. Solomon and J. L. Fahey reported the first therapeutic plasmapheresis procedure.

1961 - The role of platelet concentrates in reducing mortality from hemorrhage in cancer patients was recognized.

1962 - The first antihemophilic factor (AHF) concentrate to treat coagulation disorders in hemophilia patients was developed through the process of fractionation.

1962 - The United States reported approximately 4,400 hospital Blood banks, 123 community Blood centers and 55 American Red Cross Blood centers, collecting, in aggregate total, as many as six million units of Blood per year.

1964 - Plasmapheresis was introduced as a means of collecting Plasma for fractionation.

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

1967 - National Blood Resources Program at National Heart and Lung Institute is established.

1969 - S. Murphy and F. Gardner demonstrated the feasibility of storing Platelets at room temperature, which revolutionized platelet transfusion therapy.

1971 - Hepatitis B surface antigen (HBsAg) testing of donated Blood began in the United States.

1972 - Apheresis was used to extract one cellular component, returning the rest of the Blood to the donor.

1979 - A new anticoagulant preservative, CPDA-1, which 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 is introduced.

1979 - CPDA -1 was introduced - new solution was added : Adenine ----- keep blood for 42 days
1980 Carl Walter and W. P. Murphy, introduced the plastic bag collection

Early 1980s - Doctors began training in the specialties of Blood transfusion and actively participated in patient care.

1983 - Newly introduced Blood additive solutions resulted in extend shelf life of treated red Blood cells to 42 days.

1985 - The first Blood screening test to detect the probable presence of HIV was licensed and implemented by Blood banks in the United States.

1987 - Two tests for screening for indirect evidence of hepatitis C were developed and implemented: hepatitis B core antibody (anti-HBc) and the alanine aminotransferase test (ALT).

1989 - In the United States, human T lymphotropic virus I antibody (anti-HTLV-I) testing of donated Blood began.

1990 - The first specific test for hepatitis C was introduced. This 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) was implemented.

1996 - Testing of donated Blood for the HIV p24 antigen began. The test did not do a complete job, but improved on the previous tests, in that, the time taken to clear donated Blood for use was shortened substantially.
1996 and 1997 - The United States Government issued reports suggesting problems with the Blood supply in the United States, and suggested methods and procedures to improve Blood safety, including regulatory reform.

1999 - The Blood manufacturing community began implementation of Nucleic Acid Amplification Testing (NAT) under the FDAs Investigational New Drug (IND) application process. NAT employs a testing technology that directly detects the genetic materials of viruses like HCV and HIV.

References
Harmening, Denise (2005), Modern Blood Banking and Transfusion Practices, 5th ed., F. A. Davis Co., Philadelphia, Pennsylvania Hillyer, Christopher D., Silberstein, Leslie E., Ness, Paul, and Anderson, Kenneth C.,l (2003), Blood Banking and Transfusion Medicine, Basic Principle and Practice, 1st ed., Elsevier Science, Singapore Rudmann, Sally V., (2005) Blood Banking and Transfusion Medicine, 2nd ed., Elsevier, Saunders, USA www.bloodbook.com/trans.history. html

To the man with insight,

it is all clear; to the well-informed, it is all plain.
Proverbs 8:9