History of Blood Transfusion Timeline

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, using sodium phosphate.

Image source: John Braxton Hicks

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. He won the Nobel Prize in Physiology or Medicine in 1930 for this discovery.

Image source: Karl Landsteiner

George Washington Crile is credited with performing the first surgery using a direct blood transfusion in 1906 at St. Alexis Hospital in Cleveland.

Image source: George Washington Crile

Czech physician Jan Janský also discovered the human blood groups; in 1907 he classified blood into four groups: I, II, III, IV.

Image source: Jan Janský

American physician William Lorenzo Moss developed a blood typing technique in 1910, popularly known as the Moss system of blood typing, that was widely used until World War II.

The Belgian doctor Albert Hustin performed the first non-direct transfusion on March 27, 1914, though this involved a diluted solution of blood using sodium citrate as an anticoagulant.

Another important breakthrough came between 1937 and 1940 when Karl Landsteiner, Alex Wiener, Philip Levine, and R.E. Stetson discovered the Rh blood group system, explaining most previously unexplained transfusion reactions.

Image source: Rh blood group system

The First World War (1914–1918) acted as a catalyst for the rapid development of blood banks and transfusion techniques.

Image source: World War I

Their first report in March 1915 showed that gelatine, agar, blood serum extracts, starch and beef albumin proved to be useless preservatives for stored blood.

In June 1915, Robertson 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 transfusion.

Image source: JAMA

In October 1915, Robertson performed his first wartime transfusion with a syringe to a patient who had multiple shrapnel wounds.

Robertson published his findings in the British Medical Journal in 1916 and, with help from eminent physician Edward William Archibald and others, persuaded the British authorities of the merits of blood transfusion.

Image source: The BMJ

Robertson went on to establish the first blood-transfusion apparatus at a Casualty Clearing Station on the Western Front in the spring of 1917.

Image source: Casualty Clearing Station

An army officer attached to the RAMC in 1917 became instrumental in establishing the first blood banks in preparation for the anticipated Third Battle of Ypres.

Image source: Battle of Passchendaele

Gordon R. Ward, writing in the correspondence columns of the British Medical Journal, proposed the use of blood plasma as a substitute for whole blood for transfusion purposes as early as 1918.

Image source: Blood plasma

With war appearing imminent in 1938, the War Office created the Army Blood Supply Depot (ABSD) in Bristol, headed by Lionel Whitby and controlling four large blood-depots around the country.

A large project known as 'Blood for Britain' began in August 1940 to collect blood in New York City hospitals for the export of dried plasma to Britain during World War II.

The secretary of the British Red Cross, Percy Lane Oliver, established the world's first voluntary blood-donor service in 1921. By 1925 it was providing services for almost 500 patients, and it was incorporated into the British Red Cross in 1926.

Image source: Percy Lane Oliver

Alexander Bogdanov founded an academic institution devoted to the science of blood transfusion in Moscow in 1925. Bogdanov died in 1928 as a result of one of his experiments, when the blood of a student with malaria and tuberculosis was given to him in an exchange transfusion.

Image source: Alexander Bogdanov

Sergei Yudin performed such a transfusion successfully for the first time on March 23, 1930, and reported his first seven clinical transfusions with cadaveric blood at the Fourth Congress of Ukrainian Surgeons at Kharkiv in September.

Frederic Durán-Jordà established one of the earliest blood banks during the Spanish Civil War in 1936. He fled to Britain in 1938 and worked with Dr Janet Vaughan at Hammersmith Hospital to establish a system of national blood banks in London.

Image source: Spanish Civil War

In 1937 Bernard Fantus, director of therapeutics at the Cook County Hospital in Chicago, established the first hospital blood bank in the United States, coining the term 'blood bank'.

Image source: Bernard Fantus

This system evolved into the National Blood Transfusion Service established in 1946, the first national blood transfusion service to be implemented.

Image source: NHS Blood and Transplant

Carl W. Walter introduced the plastic bag for blood collection in 1950, revolutionizing storage and making blood banks more efficient.

Image source: Carl Walter

Further extending the shelf-life of stored blood up to 42 days was an anticoagulant preservative, CPDA-1, introduced in 1979, which increased the blood supply and facilitated resource-sharing among blood banks.

With the introduction of ELISA testing in 1985, the transmission of HIV during transfusion has dropped dramatically.

Image source: ELISA

The rate of hospitalizations with a blood transfusion nearly doubled from 1997, rising from a rate of 40 stays to 95 stays per 10,000 population by 2011.

As of 2006 about 15 million units of blood products were transfused per year in the United States.

In the United States, blood transfusions were performed nearly 3 million times during hospitalizations in 2011, making it the most common procedure performed. It was the most common procedure for patients 45 and older, and among the top five for patients aged 1 to 44.

In 2012, a national blood policy was in place in 70% of countries, and 69% of countries had specific legislation covering the safety and quality of blood transfusion.

Image source: World Health Organization

By 2013 the number had declined to about 11 million units, because of the shift towards laparoscopic surgery and other surgical advances and studies showing that many transfusions were unnecessary.

According to the New York Times, changes in medicine eliminated the need for millions of blood transfusions. Blood bank revenue fell, possibly reaching $1.5 billion a year in 2014 from a high of $5 billion in 2008, and the Red Cross predicted job losses as high as 12,000 within three to five years.

Image source: American Red Cross

As of 2019, the trend of declining transfusions appeared to be stabilizing, with 10,852,000 RBC units, 2,243,000 platelet units, and 2,285,000 plasma units transfused in the United States.

The risk of severe bacterial infection is estimated, as of 2020, at about 1 in 2,500 platelet transfusions, and 1 in 2,000,000 red blood cell transfusions.

A number of blood substitutes have been explored, but all have serious limitations, and as of 2023 no blood substitutes have been approved for use in transfusions; however the EU, Russia, South Africa and Mexico have approved them in other clinical settings.