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performed the rate of hospitalizations with a blood transfusion nearly doubled from 1997 from a rate of 40 stays to 95 stays per 10 000 population it was the most common procedure performed for patients 45 years of age and older in 2011 and among the top five most common for patients between the ages of 1 and 44 years 78 according to the new york times changes in medicine have eliminated the need for millions of blood transfusions which is good news for patients getting procedures like coronary bypasses and other procedures that once required a lot of blood and blood bank revenue is falling and the decline may reach 1 5 billion a year this year 2014 from a high of 5 billion in 2008 in 2014 the red cross was predicting job losses as high as 12 000 within the next three to five years roughly a quarter of the total in the industry 79 as of 2019 the trend of declining transfusions appeared to be stabilizing with 10 852 000 rbc units transfused in the united states 80 history edit beginning with william harvey s experiments on the circulation of blood recorded research into blood transfusion began in the 17th century with successful experiments in transfusion between animals however successive attempts by physicians to transfuse animal blood into humans gave variable often fatal results 81 early attempts edit animal blood edit richard lower pioneered the first blood transfusion from animal to human in 1665 at the royal society working at the royal society in the 1660s the physician richard lower began examining the effects of changes in blood volume on circulatory function and developed methods for cross circulatory study in animals obviating clotting by closed arteriovenous connections the new instruments he was able to devise enabled him to perform the first reliably documented successful transfusion of blood in front of his distinguished colleagues from the royal society 82 83 according to lower s account towards the end of february 1665 i selected one dog of medium size opened its jugular vein and drew off blood until its strength was nearly gone then to make up for the great loss of this dog by the blood of a second i introduced blood from the cervical artery of a fairly large mastiff which had been fastened alongside the first until this latter animal showed it was overfilled by the inflowing blood after he sewed up the jugular veins the animal recovered with no sign of discomfort or of displeasure citation needed lower had performed the first blood transfusion between animals he was then requested by the honorable robert boyle to acquaint the royal society with the procedure for the whole experiment which he did in december 1665 in the society s philosophical transactions 84 the first blood transfusion from animal to human was administered by jean baptiste denys eminent physician to king louis xiv of france on june 15 1667 85 he transfused the blood of a sheep into a 15 year old boy who survived the transfusion 86 denys performed another transfusion into a labourer who also survived both instances were likely due to the small amount of blood that was actually transfused into these people this allowed them to withstand the allergic reaction denys s third patient to undergo a blood transfusion was swedish baron gustaf bonde he received two transfusions after the second transfusion bonde died 87 in the winter of 1667 denys performed several transfusions on antoine mauroy with calf s blood on the third account mauroy died 88 six months later in london lower performed the first human transfusion of animal blood in britain where he superintended the introduction in a patient s arm at various times of some ounces of sheep s blood at a meeting of the royal society and without any inconvenience to him the recipient was arthur coga the subject of a harmless form of insanity sheep s blood was used because of speculation about the value of blood exchange between species it had been suggested that blood from a gentle lamb might quiet the tempestuous spirit of an agitated person and that the shy might be made outgoing by blood from more sociable creatures coga received 20 shillings equivalent to 206 in 2025 to participate in the experiment 89 lower went on to pioneer new devices for the precise control of blood flow and the transfusion of blood his designs were substantially the same as modern syringes and catheters 84 shortly after lower moved to london where his growing practice soon led him to abandon research 90 these early experiments with animal blood provoked a heated controversy in britain and france 87 finally in 1668 the royal society and the french government both banned the procedure the vatican condemned these experiments in 1670 blood transfusions fell into obscurity for the next 150 years 91 human blood edit james blundell successfully transfused human blood in 1818 the science of blood transfusion dates to the first decade of the 20th century with the discovery of distinct blood types leading to the practice of mixing some blood from the donor and the receiver before the transfusion an early form of cross matching 92 in the early 19th century british obstetrician james blundell made efforts to treat hemorrhage by transfusion of human blood using a syringe in 1818 after experiments with animals he performed the first successful transfusion of human blood to treat postpartum hemorrhage at guy s hospital in london 93 94 blundell used the patient s husband as a donor and extracted four ounces of blood from his arm to transfuse into his wife 95 during the years 1825 and 1830 blundell performed 10 transfusions five of which were beneficial and published his results 96 he also invented a number of instruments for the transfusion of blood 97 he made a substantial amount of money from this endeavour roughly 2 million 50 million real dollars 98 in 1840 samuel armstrong lane aided by blundell performed the first successful whole blood transfusion to treat haemophilia at st george s hospital medical school in london 99 however early transfusions were risky and many resulted in the death of the patient by the late 19th century blood transfusion was regarded as a risky and dubious procedure and was largely shunned by the medical establishment work to emulate james blundell continued in edinburgh in 1845 the edinburgh journal described the successful transfusion of blood to a woman with severe uterine bleeding subsequent transfusions were successful with patients of james young simpson after whom the simpson memorial maternity pavilion in edinburgh was named 100 various isolated reports of successful transfusions emerged towards the end of the 19th century 101 the largest series of early successful transfusions took place at the edinburgh royal infirmary between 1885 and 1892 edinburgh later became the home of the first blood donation and blood transfusion services 100 20th century edit william stewart halsted m d 1852 1922 performed one of the first blood transfusions in the united states only in 1901 when the austrian karl landsteiner discovered three human blood groups o a and b did blood transfusion achieve a scientific basis and become safer 102 landsteiner discovered that adverse effects arise from mixing blood from two incompatible individuals he found that mixing incompatible types triggers an immune response and the red blood cells clump the immunological reaction occurs when the receiver of a blood transfusion has antibodies against the donor blood cells the destruction of red blood cells releases free hemoglobin into the bloodstream which can have fatal consequences landsteiner s work made it possible to determine blood group and allowed blood transfusions to take place much more safely for his discovery he won the nobel prize in physiology and medicine in 1930 many other blood groups have been discovered since 103 george washington crile is credited with performing the first surgery using a direct blood transfusion in 1906 at st alexis hospital in cleveland while a professor of surgery at case western reserve university 104 jan janský also discovered the human blood groups in 1907 he classified blood into four groups i ii iii iv 105 his nomenclature is still used in russia and in states of the former ussr in which blood types o a b and ab are respectively designated i ii iii and iv american physician william lorenzo moss s 1876 1957 developed a blood typing technique in 1910 popularly known as moss system of blood typing that was widely used until world war ii 106 107 the moss technique also used roman numerals using i ii iii iv to correspond to ab a b and o respectively 108 a potentially dangerous overlap with janský s classification william stewart halsted 1852 1922 an american surgeon performed one of the first blood transfusions in the united states he had been called to see his sister after she had given birth he found her moribund from blood loss and in a bold move withdrew his own blood transfused his blood into his sister and then operated on her to save her life 109 blood banks in wwi edit main article blood bank luis agote 2nd from right overseeing one of the first safe and effective blood transfusions in 1914 old glass used for blood transfusion while the first transfusions had to be made directly from donor to receiver before coagulation it was discovered that by adding anticoagulant and refrigerating the blood it was possible to store it for some days thus opening the way for the development of blood banks john braxton hicks was the first to experiment with chemical methods to prevent the coagulation of blood at st mary s hospital london in the late 19th century his attempts using phosphate of soda however proved unsuccessful the belgian doctor albert hustin performed the first non direct transfusion on march 27 1914 though this involved a diluted solution of blood the argentine doctor luis agote used a much less diluted solution in november of the same year both used sodium citrate as an anticoagulant 110 the first world war 1914 1918 acted as a catalyst for the rapid development of blood banks and transfusion techniques francis peyton rous and joseph r turner at the rockefeller university then the rockefeller institute for medical research made the first important discoveries that blood typing was necessary to avoid blood clumping coagulation and blood samples could be preserved using chemical treatment 111 112 their first report in march 1915 showed that gelatine agar blood serum extracts starch and beef albumin proved to be useless preservatives 113 however building on the same experiment they discovered that a mixture sodium citrate and glucose dextrose solution was a perfect preservative as they reported in february issue of the journal of experimental medicine the preserved bloods were just like fresh bloods and that they function excellently when reintroduced into the body 114 blood could be preserved for up to four weeks an accompanying experiment using citrate saccharose sucrose mixture was also a success which could maintain blood cells for two weeks 115 this use of citrate and sugars sometimes known as rous turner solution was the foundation for the development of blood banks and improvement of transfusion method 116 117 another discovery of rous and turner was the most critical step in the safety of blood transfusion rous was well aware that landsteiner s concept of blood types had not yet found practical value as he remarked the fate of landsteiner s effort to call attention to the practical bearing of the group differences in human bloods provides an exquisite instance of knowledge marking time on technique transfusion was still not done because until at least 1915 the risk of clotting was too great 118 in june 1915 they made a crucial report in the journal of the american medical association that agglutination could be avoided if the blood samples of the donor and recipient were tested before which they called a rapid and simple method for testing blood compatibility sodium citrate was used to dilute the blood samples and after mixing the recipient s and donor s blood in 9 1 and 1 1 parts blood would either clump or remain watery after 15 minutes according to their advice blood without clumping should always be chosen if possible 119 canadian doctor and lieutenant lawrence bruce robertson became instrumental in persuading the royal army medical corps to adopt the use of blood transfusion at the casualty clearing stations for the wounded in october 1915 robertson performed his first wartime transfusion with a syringe to a patient who had multiple shrapnel wounds he followed this up with four subsequent transfusions in the following months and his success was reported to sir walter morley fletcher director of the medical research committee 120 world war ii russian syringe for direct inter human blood transfusion robertson published his findings in the british medical journal in 1916 and with the help of a few like minded individuals including the eminent physician edward william archibald was able to persuade the british authorities of the merits of blood transfusion robertson went on to establish the first blood transfusion apparatus at a casualty clearing station on the western front in the spring of 1917 120 121 robertson did not test crossmatching so that one died of hemolysis in his 1916 transfusion and three in 1917 122 oswald hope robertson a medical researcher and u s army officer was attached to the ramc in 1917 where he became instrumental in establishing the first blood banks in preparation for the anticipated third battle of ypres 123 he used sodium citrate as the anticoagulant blood was extracted from punctures in the vein and was stored in bottles at british and american casualty clearing stations along the front robertson also experimented with preserving separated red blood cells in iced bottles 121 geoffrey keynes a british surgeon developed a portable machine that could store blood to enable transfusions to be carried out more easily expansion edit alexander bogdanov established a scientific institute to research the effects of blood transfusion in moscow 1925 the secretary of the british red cross percy lane oliver established the world s first blood donor service in 1921 in that year oliver was contacted by king s college hospital where they were in urgent need of a blood donor 124 after providing a donor oliver set about organizing a system for the voluntary registration of blood donors at clinics around london with sir geoffrey keynes appointed as a medical adviser volunteers were subjected to a series of physical tests to establish their blood group the london blood transfusion service was free of charge and expanded rapidly in its first few years of operation by 1925 it was providing services for almost 500 patients it was incorporated into the structure of the british red cross in 1926 similar systems developed in other cities including sheffield manchester a...