Editing Blood bank (section)

===First World War===
The [[World War I|First World War]] acted as a catalyst for the rapid development of blood banks and transfusion techniques. Inspired by the need to give blood to wounded soldiers in the absence of a donor, <ref name=":3">{{Cite web |date=2010 |title=The Rockefeller University Hospital Centennial – The First Blood Bank |url=https://centennial.rucares.org/index.php?page=blood_bank |access-date=2022-03-18 |website=centennial.rucares.org |publisher=The Rockefeller University}}</ref> [[Francis Peyton Rous]] at the [[Rockefeller University]] (then The Rockefeller Institute for Medical Research) wanted to solve the problems of blood transfusion.<ref name=":3" /> With a colleague, Joseph R. Turner, he made two critical discoveries: blood typing was necessary to avoid blood clumping (coagulation) and blood samples could be preserved using chemical treatment.<ref name=":1">{{Cite news |last=Brody |first=Jane E. |date=1970-02-17 |title=Dr. Peyton Rous, Nobel Laureate, Dies |language=en-US |pages=43 |work=The New York Times |url=https://www.nytimes.com/1970/02/17/archives/dr-peyton-rous-nobel-laureate-dies.html |access-date=2022-03-18 |issn=0362-4331}}</ref> Their report in March 1915 to identify possible blood preservative was of a failure. The experiments with gelatine, agar, blood serum extracts, starch and beef albumin proved useless.<ref>{{Cite journal |last1=Rous |first1=P. |last2=Turner |first2=J. R. |date=1915-03-01 |title=On the preservation in vitro of living erythrocytes |url=http://ebm.sagepub.com/lookup/doi/10.3181/00379727-12-74 |journal=Experimental Biology and Medicine |language=en |volume=12 |issue=6 |pages=122–124 |doi=10.3181/00379727-12-74 |issn=1535-3702 |s2cid=88016286|url-access=subscription }}</ref> 

In June 1915, they made the first important 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. They developed a rapid and simple method for testing blood compatibility in which coagulation and the suitability of the blood for transfusion could be easily determined. They used [[sodium citrate]] to dilute the blood samples, and after mixing the recipient's and donor's blood in 9:1 and 1:1 parts, blood would either clump or remain watery after 15 minutes. Their result with a medical advice was clear:<blockquote>[If] clumping is present in the 9:1 mixture and to a less degree or not at all in the 1:1 mixture, it is certain that the blood of the patient agglutinates that of the donor and may perhaps hemolyze it. Transfusion in such cases is dangerous. Clumping in the 1:1 mixture with little or none in the 9:1 indicates that the plasma of the prospective donor agglutinates the cells of the prospective recipient. The risk from transfusing is much less under such circumstances, but it may be doubted whether the blood is as useful as one which does not and is not agglutinated. A blood of the latter kind should always be chosen if possible.<ref>{{Cite journal |last1=Rous |first1=Peyton |last2=Turner |first2=J. R. |date=1915 |title=A rapid and simple method of testing donors for transfusion |url=https://doi.org/10.1001/jama.1915.02570500028011 |journal=Journal of the American Medical Association |volume=LXIV |issue=24 |pages=1980–1982 |doi=10.1001/jama.1915.02570500028011|url-access=subscription }}</ref></blockquote>Rous was well aware that Austrian physician [[Karl Landsteiner]] had discovered blood types a decade earlier, but the practical usage was not yet developed, as he described: "The fate of Landsteiner's effort to call attention to the practical bearing of the group differences in human bloods provides an exquisite instance of knowledge marking time on technique. Transfusion was still not done because (until at least 1915), the risk of clotting was too great."<ref name=":4">{{Cite journal |last1=Rous |first1=P. |author-link=Francis Peyton Rous |year=1947 |title=Karl Landsteiner. 1868–1943 |journal=[[Obituary Notices of Fellows of the Royal Society]] |volume=5 |issue=15 |pages=294–324 |doi=10.1098/rsbm.1947.0002 |s2cid=161789667}}</ref> In February 1916, they reported in the ''[[Journal of Experimental Medicine]]'' the key method for blood preservation. They replaced the additive, gelatine, with a mixture sodium citrate and glucose ([[dextrose]]) solution and found: "in a mixture of 3 parts of human blood, 2 parts of [[Saline (medicine)|isotonic]] citrate solution (3.8 per cent sodium citrate in water), and 5 parts of isotonic dextrose solution (5.4 per cent dextrose in water), the cells remain intact for about 4 weeks."<ref name=":0">{{Cite journal |last1=Rous |first1=Peyton |last2=Turner |first2=J. R. |date=1916 |title=The preservation of living red blood cells in vitro : i. Methods of preservation. |url=https://rupress.org/jem/article/23/2/219/8685/THE-PRESERVATION-OF-LIVING-RED-BLOOD-CELLS-IN |journal=Journal of Experimental Medicine |language=en |volume=23 |issue=2 |pages=219–237 |doi=10.1084/jem.23.2.219 |issn=1540-9538 |pmc=2125399 |pmid=19867981}}</ref> A separate report indicates the use of citrate-saccharose (sucrose) could maintain blood cells for two weeks.<ref>{{Cite journal |last1=Rous |first1=Peyton |last2=Turner |first2=J. R. |date=1916 |title=The preservation of living red blood cells in vitro: ii. The transfusion of kept cells. |url=https://rupress.org/jem/article/23/2/239/8672/THE-PRESERVATION-OF-LIVING-RED-BLOOD-CELLS-IN |journal=Journal of Experimental Medicine |language=en |volume=23 |issue=2 |pages=239–248 |doi=10.1084/jem.23.2.239 |issn=1540-9538 |pmc=2125395 |pmid=19867982}}</ref> They noticed that the preserved bloods were just like fresh bloods and that they "function excellently when reintroduced into the body."<ref name=":0" /> The use of sodium citrate with sugar, sometimes known as Rous-Turner solution, was the main discovery that paved the way for the development of various blood preservation methods and blood bank.<ref>{{Cite journal |last=Hess |first=J. R. |date=2006 |title=An update on solutions for red cell storage |url=https://doi.org/10.1111/j.1423-0410.2006.00778.x |journal=Vox Sanguinis |volume=91 |issue=1 |pages=13–19 |doi=10.1111/j.1423-0410.2006.00778.x |issn=0042-9007 |pmid=16756596|s2cid=35894834 |url-access=subscription }}</ref><ref>{{Cite journal |last1=Hanigan |first1=W. C. |last2=King |first2=S. C. |date=1996 |title=Cold blood and clinical research during World War I |url=https://academic.oup.com/milmed/article/161/7/392/4843377 |journal=Military Medicine |volume=161 |issue=7 |pages=392–400 |doi=10.1093/milmed/161.7.392 |issn=0026-4075 |pmid=8754712|doi-access=free |url-access=subscription }}</ref>   

Canadian Lieutenant [[Lawrence Bruce Robertson]] was instrumental in persuading the [[Royal Army Medical Corps]] (RAMC) to adopt the use of blood transfusion at the [[Casualty Clearing Station]]s for the wounded. In October 1915, Robertson performed his first wartime transfusion with a syringe to a patient who had multiple shrapnel wounds. He followed this up with four subsequent transfusions in the following months, and his success was reported to Sir [[Walter Morley Fletcher]], director of the [[Medical Research Council (United Kingdom)|Medical Research Committee]].{{citation needed|date=April 2022}}

[[File:Direct-blood-transfusion.jpg|thumb|left|World War II Russian syringe for direct inter-human blood transfusion]]

Robertson published his findings in the ''[[British Medical Journal]]'' in 1916, and—with the help of a few like minded individuals (including the eminent physician [[Edward William Archibald]])—was able to persuade the British authorities of the merits of blood transfusion. Robertson went on to establish the first blood transfusion apparatus at a Casualty Clearing Station on the [[Western Front (World War I)|Western Front]] in the spring of 1917.<ref name="Pelis">{{cite journal|author=Kim Pelis|title=Taking Credit: The Canadian Army Medical Corps and the British Conversion to Blood Transfusion in WWI|journal=Journal of the History of Medicine and Allied Sciences|url=https://muse.jhu.edu/journals/journal_of_the_history_of_medicine_and_allied_sciences/v056/56.3pelis.html|year=2001|doi=10.1093/jhmas/56.3.238|volume=56|issue=3|pages=238–277|pmid=11552401|url-access=subscription}}</ref>

[[Oswald Hope Robertson]], a medical researcher and {{nowrap|U.S. Army}} officer, worked with Rous at the Rockefeller between 1915 and 1917, and learned the blood matching and preservation methods.<ref>{{Cite journal |last1=Stansbury |first1=Lynn G. |last2=Hess |first2=John R. |date=2009 |title=Blood transfusion in World War I: the roles of Lawrence Bruce Robertson and Oswald Hope Robertson in the "most important medical advance of the war" |url=https://linkinghub.elsevier.com/retrieve/pii/S0887-7963(09)00033-9 |journal=Transfusion Medicine Reviews |volume=23 |issue=3 |pages=232–236 |doi=10.1016/j.tmrv.2009.03.007 |issn=1532-9496 |pmid=19539877|url-access=subscription }}</ref> He was attached to the RAMC in 1917, where he was instrumental in establishing the first blood banks, with soldiers as donors, in preparation for the anticipated [[Battle of Passchendaele|Third Battle of Ypres]].<ref>{{cite web|url=https://www.pbs.org/wnet/redgold/history/timeline3.html|title=Red Gold: the Epic Story of Blood|publisher=PBS|url-status=live|archive-url=https://web.archive.org/web/20150510070430/http://www.pbs.org/wnet/redgold/history/timeline3.html|archive-date=2015-05-10}}</ref> He used [[Monosodium citrate|sodium citrate]] as the anticoagulant, and the blood was extracted from punctures in the vein, and was stored in bottles at British and American Casualty Clearing Stations along the Front. He also experimented with preserving separated [[red blood cell]]s in iced bottles.<ref name="Pelis"/> [[Geoffrey Keynes]], a British surgeon, developed a portable machine that could store blood to enable transfusions to be carried out more easily.