The Story of Blood for Shock Resuscitation: How the Pendulum Swings.

Whole blood transfusion (WBT) began in 1667 as a treatment for mental illness, with predictably poor results. Its therapeutic utility and widespread use were initially limited by deficiencies in transfusion science and antisepsis. James Blundell, a British obstetrician, was recognized for the first allotransfusion in 1825. However, WBT did not become safe and therapeutic until the early 20th century, with the advent of reliable equipment, sterilization, and blood typing. The discovery of citrate preservation in World War I allowed a separation of donor from recipient and introduced the practice of blood banking. During World War II, Elliott and Strumia were the first to separate whole blood into blood component therapy (BCT), producing dried plasma as a resuscitative product for "traumatic shock." During the 1970s, infectious disease, blood fractionation, and financial opportunities further drove the change from WBT to BCT, with few supporting data. Following a period of high-volume crystalloid and BCT resuscitation well into the early 2000s, measures to avoid the resulting iatrogenic resuscitation injury were developed under the concept of damage control resuscitation. Modern transfusion strategies for hemorrhagic shock target balanced BCT to reapproximate whole blood. Contemporary research has expanded the role of WBT to therapy for the acute coagulopathy of trauma and the damaged endothelium. Many US trauma centers are now using WBT as a front-line treatment in tandem with BCT for patients suffering hemorrhagic shock. Looking ahead, it is likely that WBT will once again be the resuscitative fluid of choice for patients in hemorrhagic shock.

Sixty years of blood transfusion: a memoir.

Paul Schmidt was born in 1925 into the Greatest Generation. Events during military service decided him on the study of medicine. Early research training in red cell preservation that continued during his medical studies opened a 20-year career at the National Institutes of Health (NIH). Beginning in 1954 at the Blood Bank of the NIH Clinical Center, he had exposure to the pioneers who had translated transfusion's wartime beginnings into civilian applications. Work inside the unique NIH clinical research atmosphere together with many of his students provided a fertile field for the growth of what has become transfusion medicine. Topics described range from early studies on platelets and on hepatitis to the background in Washington health politics leading to the National Blood Policy. National and global organizational activity and a second career in community blood service added to his 65 years of experience. The story as transfusion history is presented as a template for future progress.

Scott Murphy, MD: platelet storage pioneer.

Dr Scott Murphy was a leading authority in the science of platelet storage for transfusion. Among the first to advocate room-temperature storage, his work enabled the extension of platelet shelf life, which facilitated the development of aggressive medical and surgical therapies requiring intensive platelet support. During a 38-year career, he characterized the metabolism of stored platelets, worked to optimize storage conditions, and developed a landmark standard for the assessment of platelet quality. As a clinical hematologist, he was devoted to his patients, providing compassionate, comforting care. He was also a cherished mentor, a sage advisor, a fast friend, and a dedicated family man. Dr Murphy was one of those rare, great, humble men who inspire and enrich everyone around him. Truly one of transfusion medicine's leaders, Scott is remembered by those whose lives he touched for his warmth, wit, and wisdom.

Storage of whole blood for up to 24 hours at ambient temperature before component preparation: implementation in the Netherlands.

The aim of this article is to reflect on the historical background on what urged the authors in the 1980s to investigate the prolonged storage of whole blood at ambient temperature before component preparation, the routine implementation of the method in the Netherlands, and the effect on logistics and plasma procurement.

Cord blood banking: a historical perspective.

Umbilical cord blood (UCB) contains stem and progenitor cells capable of restoring haematopoietic and immunological function in vivo. UCB is currently used as an alternative source of haematopoietic stem cells for transplantation in patients suffering from haematological malignancies, bone marrow failures and inherited metabolic disorders. In order to facilitate transplantation, large repositories of frozen cord blood units (CBUs) from altruistic donations have been established in many parts of the world and to date there are more than 300,000 units stored worldwide. These products have been banked under stringent quality conditions, in order to ensure their safety and efficacy. The development and evolution of the policies and procedures currently in use in cord blood banking have been largely influenced by the clinical results of cord blood transplantation. This review aims to provide a historical overview of the various developments in the field of cord blood banking from its inception, highlighting the relevant aspects in their collection, banking and release that are known to influence the clinical outcome of these transplants.

Alexander Fleming, citrated blood and penicillin: paths not pursued and applications delayed.

Ninety years ago Alexander Fleming (later to discover penicillin) jointly wrote a description of the use of indirect transfusions of citrated blood at a World War 1 (WW1) base hospital. It was the longest series yet to be published, incorporating what was then a novel procedure for treating war casualties. Returning to civilian life Fleming, a qualified surgeon and bacteriologist, chose a different career path, and not until the wars of the late 1930s were the advances in transfusion in WW1 fully incorporated into the management of trauma and haemorrhage. Like penicillin, the benefits of indirect transfusion were only slowly realised.

Las bolsas plásticas para sangre: un hito en la historia de la tecnología transfusional / Plastic blood bags: a landmark in the history of transfusional technology

Se presenta en este artículo una breve historia de los métodos utilizados para transfundir sangre humana, partiendo de las transfusiones de brazo a brazo, el uso de frascos de vidrio y la introducción de las bolsas de PVC en los Estados Unidos a mediados del siglo XX. Finalmente, se hace hincapié en el desarrollo de las bolsas para sangre en la Argentina, un trabajo interdisciplinario en el cual confluyeron la industria farmacéutica y los usuarios médicos. (AU)

Las bolsas plásticas para sangre: un hito en la historia de la tecnología transfusional / Plastic blood bags: a landmark in the history of transfusional technology

Se presenta en este artículo una breve historia de los métodos utilizados para transfundir sangre humana, partiendo de las transfusiones de brazo a brazo, el uso de frascos de vidrio y la introducción de las bolsas de PVC en los Estados Unidos a mediados del siglo XX. Finalmente, se hace hincapié en el desarrollo de las bolsas para sangre en la Argentina, un trabajo interdisciplinario en el cual confluyeron la industria farmacéutica y los usuarios médicos.

An update on solutions for red cell storage.

Anticoagulant and nutrient solutions allow red blood cells to be stored and transported, enabling modern blood banking. The development of these solutions has been slow, covering 90 years, and the reasons for past formulations are best understood in a historical context. Modern red cell storage solutions work well for blood banks, allowing 5-7-week storage, which means more than 90% of collected units find a recipient. Improved scientific understanding of the red cell storage lesion has shown a way to make even better storage solutions, which maintain red cell metabolism and reduce membrane loss.

Red cell freezing and its impact on the supply chain.

Red blood cells (RBC) can be frozen in glycerol solutions and stored for many years. Thawed RBC must have the glycerol removed, but the recovered cells have normal survival in humans. Freezing has been used to store RBC of rare phenotypes for more than 40 years. In the 1960s and 1970s, when medical technology and blood use were expanding rapidly and liquid whole blood and RBC storage were limited to 3 weeks, many attempts were made to expand the use of frozen RBC for meeting the needs for a stable blood supply and to have RBC reserves for emergencies. These attempts have largely been abandoned because of the cost of freezing, storing and processing, better management of the larger and longer lived RBC inventory, concerns about the safety of stored RBC that have not received the most up-to-date testing and the losses associated with the short shelf life of thawed RBC. New automated frozen RBC processing systems will potentially allow extending the outdate of thawed RBC to 2 weeks, but will not materially effect the costs or losses associated with the use of frozen RBC. RBC freezing will have little effect on the logistics of blood supply.