Blood bank

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

A 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 transfusions.

An early development leading to the establishment of blood banks occurred in 1915, when Richard Lewison of Mount Sinai Hospital, New York 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. Oswald Hope Robertson, a medical researcher and U.S. Army officer who established the depots, is now recognized as the creator of the first blood bank.

Blood donation at the Royal Melbourne Hospital during the 1940s.

By the mid-1930s, the Soviet Union had set up a system of at least sixty 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 America, 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).

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.

Further extending the shelf life of stored blood was an anticoagulant preservative, CPDA-1, introduced in 1979. It increased the blood supply and facilitated resource sharing among blood banks. Newer solutions contain adenine and extend the shelf life of red cells to 42 days.

Freezing of Red Blood Cells is done by combining them with a solution of glycerol to prevent ice crystal formation, and frozen Red Blood Cells have a stated shelf life of ten years. The process is expensive and time-consuming, and very few blood banks maintain a stock of frozen Red Blood Cells.

Plasma, usually Fresh Frozen Plasma (FFP), can be stored for up to a year if kept frozen.^[1] Platelets are typically stored for only five days since they are stored at room temperature and are considered to be at high risk for bacterial contamination. Experimental protocols involving bacteriological screening exist to extend the shelf life to seven days. The AABB, formerly the American Association of Blood Banks, maintains a Circular of Information which details the use and other important information regarding blood products.(Available in PDF format here)