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1.6 Anticoagulation
ОглавлениеAnother factor that inhibited the use of transfusions during the late 1800s was blood clotting. Because of the inability to prevent clotting, most transfusions were given by direct methods. There were many devices for direct donor‐to‐recipient transfusion that incorporated valves, syringes, and tubing to connect the veins of donor and recipient [15].
Although there were many attempts to find a suitable anticoagulant, the following remarks must be prefaced by Greenwalt’s statement that “none of them could have been satisfactory or else the history of blood transfusion would have had a fast course” [1]. Two French chemists, Prévost and Dumas, found a method to defibrinate blood and observed that such blood was effective in animal transfusions [1]. Substances tested for anticoagulation of human blood include ammonium sulfate, sodium phosphate, sodium bicarbonate, ammonium oxalate and arsphenamine, sodium iodide, and sodium sulfate [16, 17]. The delays in developing methods to anticoagulate blood for transfusion are interesting because it was known in the late 1800s that calcium was involved in blood clotting and that blood could be anticoagulated by the addition of oxalic acid. Citrates were used for laboratory experiments by physiologists, and by 1915 several papers had been published describing the use of sodium citrate for anticoagulation for transfusions [1]. It is not clear who first used citrated blood for transfusion [1]. It could have been Lewisohn [18], Hustin, or Weil [19]. In 1955, Lewisohn received the Landsteiner award from the American Association of Blood Banks for his work in the anticoagulation of blood for transfusion.