Abstract
Transfusion, as we know it today, developed into a very sophisticated treatment modality as a result of centuries of experimentation. Intraoperative cell salvage is a transfusion technique where autologous blood lost during surgery is reinfused. The success of this process relies on specialised equipment and techniques to collect, process, anticoagulate filter and reinfuse blood. Through a literature review, we collected information about the early origins of specific techniques relevant to intraoperative cell salvage: the ability to collect lost blood, to prevent collected blood from clotting, to remove debris through processing and other harmful aspects through filtering, the benefits of autologous blood transfusion, reinfusion and traditional concerns and contraindications. A culmination of knowledge specific to each of these techniques over centuries provides the background to the safe intraoperative cell salvage technique used today. In addition, we aimed to identify the reasons why specific equipment and techniques developed, why practice changed and what is still unknown. This article reviews relevant allogeneic transfusion and autotransfusion history, starting in Roman times, and includes landmark events through the centuries.
Highlights
Transfusion, as we know it today, developed into a very sophisticated treatment modality as a result of centuries of experimentation
Developments in blood transfusion answered many questions, many unanswered questions related to the best type of transfusion, technology, filters and the immunological consequences of allogeneic and autologous blood transfusion still remain
Developments in these areas thereafter enabled the growth of allogeneic blood transfusion (ABT) and intraoperative cell salvage (ICS) (Table 1)
Summary
Transfusion, as we know it today, developed into a very sophisticated treatment modality as a result of centuries of experimentation. It is very likely that these transfusions were the drinking of blood rather than intravenous transfusion.[1,2] Lindeboom wrote after a thorough investigation of the original literature that blood was taken from the boys, but no conclusion can be made that Pope Innocent VIII received this blood through transfusion.[2] The first detailed explanation of an actual intravenous blood transfusion is credited to Andreas Libavius, a chemist, physician and director of the College of Coburg, from Halle Saxony, Germany (1615).[3,4] These events were before the discovery of circulation by William Harvey (1628), and earlier accounts of blood transfusion may not imply what we define as a blood transfusion. Describe the heart and blood vessels functioning in a circle, receiving and pumping blood to organs.[5]
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