tailieunhanh - Ebook Mollison’s blood transfusion in clinical medicine (12/E): Part 2

(BQ) Part 2 book “Mollison’s blood transfusion in clinical medicine” has contents: Red cell incompatibility in vivo, haemolytic transfusion reactions, haemolytic disease of the fetus and the newborn, alternatives to allogeneic transfusion, exchange transfusion and haemapheresis, and other contents. | 10  Red cell incompatibility in vivo Transfused cells are regarded as incompatible if their sur­ vival in the recipient’s circulation is curtailed by anti­ bodies. The realization that transfusions are inevitably incompatible if donor and recipient belong to different species was made only by degrees. Transfusion of animal red cells to humans: keeping the sheep from the door The first person to transfuse a human being was Professor J Denis who, with the help of a surgeon Mr C Emmerez, gave transfusions of lamb’s blood or calf ’s blood to five different patients. His most famous, and last, recipient was a man (Mauroy) with an ‘inveterate phrensy, occasioned by a disgrace he had received in some Amours’. Denis hoped that ‘the calf ’s blood by its mildness and freshness might possibly allay the heat and ebulition of his blood’. The first two transfusions given to him apparently relieved his mania, although following the second his arm became hot, his pulse rose, sweat burst out over his forehead, he complained of pain in his kidneys, became sick to the stomach and passed black urine the next day. After this transfusion the patient became so much better that plans for a further transfusion were temporarily abandoned (Denis 1667–68). However, at the insistence of the patient’s wife a third transfusion was attempted early in 1668. There were technical difficulties and only a few drops of blood were extracted from the patient and probably no blood at all transfused. Nevertheless, the patient died the same night. The case came before the Court at Châtelet on 27 April 1668 and the cause of death was examined; it was concluded that the patient’s wife had been putting arsenic in his broth. Although the transfusion probably had nothing to do with the patient’s death, the episode was seized on by the opponents of transfusion who succeeded in having the procedure banned. Work by Blundell (1824) indicating the need to use a donor of the same species has been referred to in .

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