Blood Donation

Excerpt

Blood donation is paramount in global healthcare, with over 100 million blood units contributed annually. Blood transfusion is crucial for patients undergoing surgery, coping with trauma, managing chronic illnesses, and battling cancer. This essential procedure serves as a lifeline, providing sustenance and saving lives. Furthermore, donating blood serves as therapeutic phlebotomy for individuals with hereditary hemochromatosis, polycythemia vera, and other rare conditions. This activity provides a brief history of the origin of blood donation and testing and discusses donor eligibility and selection, the adverse effects of donation, pathogen reduction and inactivation methods for donated blood, and the significance of blood donation as a primary medical intervention.

In the early 20th century, Karl Landsteiner identified ABO blood groups. During that period, the practice of blood typing for individuals was beginning to be adopted as a universal standard practice. Initially, blood transfusions encountered significant limitations because of the difficulty in clot prevention once the blood was extracted from donors. The transfusion involved directly transferring blood from the donor to the recipient without any intermediate storage or transport. This approach was only effective on a small scale for a limited number of patients, as donors and recipients had to be connected in time and space.

Lists of donors comprised individuals locally available for donation at any time. The imperative need for a more flexible donation and storage system arose with the onset of World War I. The concept of "on-demand" blood donation was not viable for such a large-scale effort. Soldiers were succumbing to otherwise non-fatal wounds primarily because timely blood transfusions could not be performed.

Concerted efforts to develop a method for storing and transferring blood to meet wartime demands led to several discoveries. Initially, clotting was inhibited by adding citrate to the donated blood. Second, it was observed that adding glucose to the solution enabled red blood cells to maintain viability for several weeks when stored under refrigerated conditions. Captain Oswald Hope Robertson of the US Army Medical Corps was the first to "bank" blood in a manner similar to today's practices. In November 1917, before the Battle of Cambrai, Captain Robertson gathered group O blood, combined it with glucose, and stored it. This marked a crucial transition from the earlier method of "direct" to "indirect" blood donation, notably separating donors from their recipients, both geographically and temporally. This advancement significantly enhanced the practicality and utility of blood donation and transfusion.