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1.11 Plasma and the blood program during World War II

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Techniques for collection, storage, and transfusion of whole blood were not well developed during the 1930s. The outbreak of World War II added further impetus to the development of methods to store blood for periods longer than a few days. Although the method of blood anticoagulation was known by the mid‐1920s, red blood cells hemolyzed after storage in sodium citrate for 1 week. This limitation also slowed the development of blood transfusion. Although it was also known that the hemolysis could be prevented by the addition of dextrose, the practical value of this important observation was not recognized for more than a quarter of a century. Anticoagulant preservative solutions were developed by Mollison [30] in Great Britain. However, when the glucose–citrate mixtures were autoclaved, the glucose caramelized, changing the color of the solution to various shades of brown. The addition of citric acid eliminated this problem and also extended the storage time of blood to 21 days. The advance of World War II also brought an understanding of the value of plasma in patients with shock [31, 32]. In the early 1940s, Edwin J. Cohn, PhD, a Harvard biochemist, developed methods for the continuous flow separation of large volumes of plasma proteins [33, 34]. This made possible during World War II the introduction of liquid and lyophilized plasma and human albumin as the first‐line management of shock. Initial work using plasma for transfusion was carried out by John Elliott [31, 32]. This combination of technological and medical developments made it possible for Charles R. Drew to develop the “Plasma for Britain” program [35].

Transfusion Medicine

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