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["No one has ever become poor by giving,"Anne Frank.]
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In 1881, doctor William Halsted rushed to help his sister Minnie, who was hemorrhaging after childbirth.
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He quickly inserted a needle into his arm, withdrew his own blood, and transferred it to her.
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After a few uncertain minutes, she began to recover.
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Halsted didn't know how lucky they'd gotten.
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His transfusion only worked because he and his sister happened to have the same blood type—something that isn't guaranteed, even among close relatives.
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Blood types hadn't been discovered by Halsted's time, though people had been experimenting with transfusions for centuries—mostly unsuccessfully.
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In 1667, a French physician named Jean-Baptiste Denis became the first to try the technique on a human.
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Denis transfused sheep's blood into Antoine Mauroy, a man likely suffering from psychosis, in the hopes that it would reduce his symptoms.
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Afterward, Mauroy was in good spirits.
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But after a second transfusion, he developed a fever, severe pain in his lower back, intense burning in his arm, and he urinated a thick, black liquid.
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Though nobody knew it at the time, these were the signs of a dangerous immune response unfolding inside his body.
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This immune response starts with the production of proteins called antibodies, which distinguish the body's own cells from intruders.
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They do so by recognizing the foreign proteins, or antigens, embedded in an intruder's cell membrane.
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Antibodies latch onto the antigens, signaling other immune cells to attack and destroy the foreign cells.
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The destroyed cells are flushed from the body in urine.
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In extreme cases, the massive breakdown of cells causes clots in the bloodstream that disrupt the flow of blood to vital organs, overload the kidneys, and cause organ failure.
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Fortunately, Denis's patient survived the transfusion.
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But, after other cross-species transfusions proved fatal, the procedure was outlawed across Europe, falling out of favor for several centuries.
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It wasn't until 1901 that Austrian physician Karl Landsteiner discovered the blood types, the crucial step in the success of human to human blood transfusions.
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He noticed that when different types were mixed together, they formed clots.
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This happens when antibodies latch on to cells with foreign antigens, causing blood cells to clump together.
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But if the donor cells are the same blood type as the recipient's cells, the donor cells won't be flagged for destruction, and won't form clumps.
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By 1907, doctors were mixing together small amounts of blood before transfusing it.
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If there were no clumps, the types were a match.
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This enabled them to save thousands of lives, laying the foundation for modern transfusions.
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Up to this point, all transfusions had occurred in real time, directly between two individuals.
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That's because blood begins to clot almost immediately after coming into contact with air—a defense mechanism to prevent excessive blood loss after injury.
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In 1914, researchers discovered that the chemical sodium citrate stopped blood coagulating by removing the calcium necessary for clot formation.
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Citrated blood could be stored for later use—the first step in making large scale blood transfusions possible.
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In 1916, a pair of American scientists found an even more effective anticoagulant called heparin, which works by deactivating enzymes that enable clotting.
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We still use heparin today.
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At the same time, American and British researchers developed portable machines that could transport donor blood onto the battlefields of World War I.
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Combined with the newly-discovered heparin, medics safely stored and preserved liters of blood, wheeling it directly onto the battlefield to transfuse wounded soldiers.
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After the war, this crude portable box would become the inspiration for the modern-day blood bank, a fixture of hospitals around the world.
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Did you know that horseshoe crab blood plays an essential role in the medical industry?
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Find out why we're so dependent on this ancient creature with this video, or continue understanding your circulatory system by learning more about blood types.