| Administrative history | Transfusions were not a common procedure until the 1900s. Attempts had been made as far back as the 1600s, but blood transfusion was not always safe and many people died in experiments to transfuse blood from patient to patient or animals to humans. It was only when the Austrian medical scientist Karl Landsteiner developed techniques to identify blood types in 1909 that blood transfusion could be conducted with a degree of safety.
Sir Geoffrey Keynes, an alumnus of St Bartholomew's Hospital Medical College, was a pioneer of the techniques and technology of blood transfusion During the First World War, Keynes was granted a temporary commission with the Royal Army Medical Corps, and was attached to the 4th General Hospital. During this time, Keynes developed portable equipment that enabled blood transfusions to be carried out away from established medical facilities. Where there was no refrigeration available to store blood, the best hope a patient had was to get a transfusion there and then from another person. Keynes’ equipment enabled ‘indirect’ transfusions by regulating the flow of blood between the donor and the patient. His book 'Blood transfusion' (London, 1922) was the first textbook on the subject to be published in Great Britain.
Returning to Bart’s as part of the surgical team after the war, Keynes co-founded the London blood transfusion service with Percy L. Oliver in 1921. Keynes acted as medical advisor, while Oliver was a civil servant who had worked with refugees during the First World War. In October 1921, his branch of the Red Cross received a call from King's College Hospital for volunteers to give blood. A nurse in the group, Sister Linstead, gave blood and this spurred Oliver to establish a panel of potential donors from among his acquaintances who could be contacted at short notice to give fresh blood. It was agreed that volunteers should only accept calls through Oliver's office, which he called the British Red Cross Blood Transfusion Service. The donors often had to be summoned by the police, as telephones were not commonly found in private homes. Each volunteer donor underwent a physical examination and serological tests to establish the blood group and exclude infection with syphilis before being enrolled in the panel to be called up at short notice to give blood. The service was provided entirely free of charge and administrative costs were recovered from charitable donations. The donors were entitled to reclaim their expenses, but many chose not to do so. Oliver's services were called upon only 13 times in 1922, but word of the service he provided soon spread and hospitals sought his assistance 428 times in 1925.
By the 1930s blood plasma and red blood cells could be separated, and new techniques of refrigeration and plasma storage meant that blood banks could be established and blood was available for any patient who needed it. Blood types - the rhesus blood-group system - were identified around 1939-40. In the autumn of 1938, the War Office also created the Army Blood Supply Depot (ABSD) in Bristol. Recruitment from among civilians was remarkably successful and by the end of the war 756,046 donors had given blood. With the establishment of the National Health Service after the end of the war, a National Blood Transfusion Service (NBTS) was set up in 1946 under the control of the Ministry of Health, and it was NBTS stock of blood that was used used to provide transfusions at St Bartholomew's Hospital from the establishment of the department in [?]. |