Blood bank

Blood bank is a cache or bank of blood or blood components, gathered as a result of blood donation, stored and preserved for later use in blood transfusion. The term "blood bank" typically refers to a division of a hospital laboratory where the storage of blood product occurs and where proper testing is performed to reduce the risk of transfusion related events. This includes compatibility testing for transfusion and may include blood donation processing, depending on the capabilities of the facility.

History

Lewison of Mount Sinai Hospital in New York City initiated the use of sodium citrate as an anticoagulant. This discovery transformed the blood transfusion procedure from direct (vein-to-vein) to indirect. In the same year, Richard Weil demonstrated the feasibility of refrigerated storage of anticoagulated blood. The introduction of a citrate-glucose solution by Francis Peyton Rous and JR Turner two years later permitted storage of blood in containers for several days, thus opening the way for the first "blood depot" established in Britain during World War I.

In Russia Sergei Yudin pioneered the transfusion of cadaveric blood and performed this successfully for the first time on March 23, 1930. Also in 1930 Yudin organized the world's first blood bank at the Nikolay Sklifosovskiy Institute, which set an example for the establishment of further blood banks in different regions of the Soviet Union and in other countries. By the mid-1930s the Soviet Union had set up a system of at least sixty five large blood centers and more than 500 subsidiary ones, all storing "canned" blood and shipping it to all corners of the country.

News of the Soviet experience traveled to the United States, where in 1937 Bernard Fantus, director of therapeutics at the Cook County Hospital in Chicago, established the first hospital blood bank in the United States. In creating a hospital laboratory that preserved and stored donor blood, Fantus originated the term "blood bank." Within a few years, hospital and community blood banks were established across the United States. Willem Johan Kolff organised the first blood bank in Europe (in 1940).

In 1939 Charles R. Drew researched in the field of blood transfusions, developing improved techniques for blood storage, and applied his expert knowledge in developing large-scale blood banks early in World War II. Oswald Hope Robertson, a medical researcher and U.S. Army officer who established the depots, is often regarded as the creator of the first blood bank. The University of Louisville is also credited for the Blood Bank.

An important breakthrough came in 1939-40 when Karl Landsteiner, Alex Wiener, Philip Levine, and R.E. Stetson discovered the Rh blood group system, which was found to be the cause of the majority of transfusion reactions up to that time. Three years later, the introduction by J.F. Loutit and Patrick L. Mollison of acid-citrate-dextrose (ACD) solution, which reduces the volume of anticoagulant, permitted transfusions of greater volumes of blood and allowed longer term storage.

Carl Walter and W.P. Murphy, Jr., introduced the plastic bag for blood collection in 1950. Replacing breakable glass bottles with durable plastic bags allowed for the evolution of a collection system capable of safe and easy preparation of multiple blood components from a single unit of Whole Blood.

An anticoagulant preservative, CPDA-1 was introduced in 1979. It decreased wastage from expiration and facilitated resource sharing among blood banks. Newer solutions contain adenine.

Short-term Storage

Routine blood storage is limited to 21 days at 1°-6°C when treated with acid-citrate-dextrose (ACD), citrate-phosphate-dextrose (CPD) or citrate-phosphate-double dextrose (CP2D) and 35 days when treated with citrate-phosphate-dextrose-adenine (CPDA1) (5 for WB, 6 for RBC), and involves refrigeration but usually not freezing. There has been increasing controversy about whether the age of blood is a factor in transfusion efficacy, specifically on whether older blood directly or indirectly increases risks of complications. Studies have not been consistent on answering this question, with some showing that older blood is indeed less effective but with others showing no such difference.

Long-term Storage

Cryopreservation of red blood cells is done to store rare units for up to 10 years. The cells are incubated in a glycerol solution which acts as a cryoprotectant ("antifreeze") within the cells. The units are then placed in special sterile containers in a freezer at very cold temperatures. The exact temperature depends on the glycerol concentration.