The Evolution of Blood Transfusion: From Early Experiments to Life-Saving Techniques

Several decades after William Harvey demonstrated the circulation of blood, early attempts at blood transfusion began. In 1665, Richard Lower successfully kept dogs alive by transfusing blood from other dogs. Two years later, Jean-Baptiste Denys conducted the first documented blood transfusion in a human subject. While some single transfusions proved successful, recipients often experienced severe complications after their second or third transfusion. By the end of the seventeenth century, blood transfusions were banned and faded into obscurity until 1818, when English obstetrician James Blundell performed the first successful human blood transfusion to treat postpartum bleeding. Between 1825 and 1830, he carried out ten transfusions, five of which yielded positive results. Blundell not only achieved medical success but also gained financial reward, earning an equivalent of approximately $50 million today from his invention of blood transfusion instruments.

The discovery of blood types by Austrian-born American immunologist Karl Landsteiner revolutionized blood transfusions, making them a routine medical procedure. In 1901, while at Vienna’s Institute of Pathology, Landsteiner found that the blood of some individuals could agglutinate (clump) with the blood of others, leading to potentially fatal reactions due to an immunological (antigen-antibody) response. He identified three human blood groups: A, B, and C (which was later renamed O), and later discovered a fourth group, AB.

Landsteiner's blood typing laid the groundwork for the first successful transfusions of compatible blood, conducted in 1907 at Mt. Sinai Hospital in New York, and later on a large scale during World War I. By 1927, ABO blood types were being utilized in paternity suits to determine the biological parents of children. For his groundbreaking discovery of human blood groups and the ABO blood typing system, Landsteiner was awarded the Nobel Prize in 1930. In 1940, while working at the Rockefeller Institute (now Rockefeller University), he identified the Rh factor in Rhesus monkeys, which was linked to hemolytic disease of the newborn—a potentially life-threatening condition occurring when a mother and her fetus have incompatible blood types.

In 1901, Landsteiner identified the four human blood types, and four decades later, he discovered the Rh factor. In 1968, the introduction of the drug RhoGAM effectively suppressed the normal production of antibodies in Rh– mothers against their Rh+ fetus's red blood cells, successfully preventing hemolytic disease of the newborn.