The Blood Donor Evolution

By Ginny A. Roth

This 1981 poster titled “The Summer Blood Donor is a Rare Bird – Be Distinguished” from the Great Britain Department of Health and Social Security and the Control Office of Information asked the public to donate blood during the commonly slow summer months when donations slow down due in part due to school closures and vacationing donors. Unfortunately, the need for blood does not stop during the summer months and urgent appeals to eligible blood donors are ongoing.

The history of blood transfusion dates back to 1665 when English Physician Richard Lower kept dogs alive by transfusing blood from other dogs. But it wasn’t until 1818 that British obstetrician James Blundell performed the first successful transfusion of human blood to a patient for the treatment of postpartum hemorrhage.

In the late 1800s and early 1900s transfusions were not routine procedures and were performed directly from donor to recipient.  Such procedures were dangerous and often caused toxic and fatal reactions in the recipient. The prevailing medical thinking of the time concerning blood was that every person’s blood was the same, yet somehow different.  Things changed in 1901 with the groundbreaking discovery by Karl Landsteiner, an Austrian physician, of the first three human blood groups, A, B, and C (blood type C was changed to O and AB was discovered in 1902).  In 1930, Landsteiner would receive the Nobel Prize in Physiology and Medicine for his work. Based on his findings, in 1907 the first successful blood transfusion was performed by Reuben Ottenberg at Mount Sinai Hospital in New York.  In the same year, Ludvig Hektoen noted the benefit of matching blood groups of donors and patients for compatibility in transfusions. In 1912 Roger Lee demonstrated that O blood can be given to a person with any blood type (universal donor) and that a person with AB blood can receive blood from any blood group (universal recipient).

Blood transfusion became firmly established during World War I when human blood was needed for transfusions for wounded soldiers.  At this time, scientists began to study how to preserve and transport blood, as direct transfusions were complicated and impractical on the battlefield.  War time advances included the discovery of anticoagulants which improved the ability to store blood, refrigerated storage of such anti-coagulated blood, and the introduction of a citrate-glucose solution that permitted storage of blood for several days after collection, thus allowing for blood to be stored in containers for later transfusion and aiding the transition from the vein-to-vein method to indirect transfusion (recipient receives stored blood from a donor).

It was not, however, until World War II that the development of preservative solutions, the discovery of Rh blood groups, and  John Elliott’s development of the first blood container, a vacuum bottle extensively used by the Red Cross, made blood transfusions more widely and safely available.

Once blood transfusion was in wide use, storage of donated blood became a problem. The first “blood bank” in the United States was set up by Dr. Bernard Fantus in 1937 at Cook County Hospital in Chicago, Illinois.  Surgeon Charles R. Drew studied a way to preserve and store blood ready for instant use. He discovered that blood could be separated into plasma and red blood cells, and that plasma could be frozen separately, processed and reserved for a long time, and transfused without regard to blood type or matching in place of whole blood. Drew established blood banks in England and the United States during World War II. These banks saved thousands of lives by making blood transfusion available to the wounded.  In 1941, at the military’s request, the American Red Cross initiated a national blood program that collected 13.3 million pints of blood for use by the United States armed forces.  By the end of 1947, several blood banks had been established in major cities across the United States and blood donation was promoted to the public as a way of fulfilling one’s civic responsibility. In 1948, the Red Cross introduced the first nationwide civilian blood program that now supplies more than 40 percent of the blood and blood products in the United States. The Armed Services Blood Program (ASBP) was founded in 1952, and since then has collected nearly 5 million units of blood to date. It is the only blood center dedicated to providing blood exclusively to the United States military.

Today, blood transfusions remain a widely used and critical medical procedure and all blood is carefully screened for infectious diseases such as Hepatitis and HIV viruses.

According to the National Heart, Lung, and Blood Institute, nearly 5 million Americans need a blood transfusion every year.  Blood cannot be manufactured, it can only come from donors, and the American Red Cross states that one donation can help save the lives of up to three people.

Ginny A. Roth is the Curator of Prints & Photographs in the History of Medicine Division at the National Library of Medicine.