MEDICAL DICTIONARY
Blood transfusion: The transfer of blood or blood components from one person (the donor) into the bloodstream of another person (the recipient). This may be done as a lifesaving maneuver to replace blood cells or blood products lost through bleeding. Transfusion of your own blood (autologous) is the safest method but requires advance planning and not all patients are eligible. Directed donor blood allows the patient to receive blood from known donors. Volunteer donor blood is usually most readily available and, when properly tested has a low incidence of adverse events. Blood conserving techniques are an important aspect of limiting transfusion requirements.
Blood transfusion and blood conservation are complementary activities that constitute the clinical arena of transfusion medicine. A review of transfusion medicine in The New England Journal of Medicine further concludes that: - The use of blood transfusion has declined, largely because of concern about the safety of the blood supply.
- The presence now of a very safe blood supply suggests that outcomes need to be monitored to identify patients in whom transfusion may be underused (as well as overused).
- No given level of hemoglobin can, it seems, be used as a universal threshold for transfusion.
- Strategies to avoid blood transfusion will no longer be driven by the known risks, since they are now so low that no alternative is currently as safe as a blood transfusion.
- Instead, blood conservation will be driven more by issues related to the costs and inventory of blood.
Samuel Pepys recorded the first blood transfusion in his celebrated Diary. On Nov. 14, 1666, Pepys wrote that Richard Lower of the Royal Society made the first direct blood transfusion from the artery of one dog to the vein of another. Mr. Lower used quills to convey the blood.
This feat was dependent upon the discovery made by William Harvey earlier that century of the course of blood in the circulation. Harvey announced his discovery to the College of Physicians in 1616 and published his treatise on it, entitled Exercitato anatomica de motu cordis et sanguinis in animalibus, in 1628.
Sources: - LT Goodnough, ME Brecher, MH Kanter, and JP AuBuchon. Transfusion Medicine. New Engl J Med 1999; 340: 438-447; 525-533.
- S Pepys. Diary 1660-1669.
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