The study of human blood transfusion began in Europe. In the early 15th century, Pope innosant was critically ill. A doctor named carudas in Milan, Italy suggested blood transfusion. He mixed the blood of three people and added precious herbs, but the Pope immediately suffocated. From a modern medical point of view, such blood transfusion is tantamount to murder, but this is the beginning of human blood transfusion after all. Since the 17th century, doctors really began to use blood transfusion to treat patients. At that time, sheep blood was used, but patients often suffocated quickly, blood clotted and could not circulate, and sheep died together with people. It was not until more than 100 years later that Dr. lantya pointed out pointedly in his book that the blood of different animals would agglutinate red blood cells, which solved the secret of sheep blood killing. However, the blood type that is particularly important for blood transfusion has not been unveiled, and blood transfusion is still regarded as a restricted area.
Until the 19th century, blood transfusion was still a very dangerous thing. Many people died because of blood agglutination caused by blood transfusion. Therefore, although some people need to supplement their blood due to massive blood loss, they dare not give blood transfusion casually. No one dares to take the risk unless they have to.
In 1897, Austrian doctor Carl lantsteiner did his autopsy as usual. Among the cases he examined, there were no less than a thousand deaths due to blood transfusion, which he was used to. But he has been thinking about this question, that is, why some people will be saved by blood transfusion, while others will die by blood transfusion?
Once, he was playing a familiar piano music for his friends at home. He suddenly thought, is there a problem with the patient’s blood? People all think that human blood is the same, what if not? He was excited about his ideas.
The next morning, he got up and began to test his ideas. He took blood samples from 20 patients to see which could be mixed safely. He mixed the blood of each patient with that of other patients. Through microscopic observation, he found that some blood coagulated as soon as it was mixed, but some blood could be safely mixed together. So he divided them into another group. He named the two groups A and B respectively. From this, he concluded that human blood is different and some blood is mutually exclusive.
He continued his experiment and found that some blood did not coagulate with either a or B. He realized that there was another kind of blood that could be safely transfused to anyone. He named this group ab.
After several years of research, he published his findings in 1902. He believes that human blood groups are divided into four types: A, B, AB, and o. To ensure the safety of blood transfusion, doctors must determine the blood types of patients and blood donors respectively. His discovery saved millions of lives.
Later, other scientists found more than ten blood groups such as Mn, P and Rh. After years of exploration and sacrifice of countless lives, mankind finally found out the mysterious thing of blood type and entered the free kingdom of blood transfusion. Because glycoproteins outside red blood cells determine human blood type, they are called blood group substances. They exist not only in blood, but also in human saliva, sweat and urine. Chinese archaeologists excavated a female corpse 2000 years ago in Mawangdui, Changsha. They officially know that the blood group of this millennium old corpse is type A by measuring the blood group material.
Austrian doctor landesteiner proposed that there are four blood groups in humans, namely a, B, AB and o. He put forward it according to whether there is one or two of the two antigens in the blood, that is, what he called a antigen or B antigen. According to this speculation, he believes that the surface of human erythrocytes of blood group A contains antigen A, and there is B antibody against antigen B in their serum; Human red blood cells of blood group B contain B antigen, and there is a antibody against a antigen in serum; There are two antigens A and B on human erythrocytes of type AB, but there is neither anti-A antibody nor anti-B antibody in serum; There are no two antigens on the surface of human erythrocytes in type O blood, but there are two antibodies a and B in serum at the same time.
Erythrocyte blood group refers to the type of specific antigen on erythrocyte membrane. At present, there are more than 700 different erythrocyte blood group antigens. In addition to the known ABO and Rh blood groups (the two most commonly used), other blood group antigens such as Kidd, Kell, Duffy and ger bich have strong immunogenicity, which can cause a variety of serious consequences such as blood transfusion reaction, neonatal hemolysis, autoimmune hemolysis and organ transplantation failure. Therefore, their popularity is far less than that of ABO blood. According to statistics, more than 1% of patients with hemolysis and blood transfusion reactions every year. Therefore, the correct identification of erythrocyte blood group antigen and specific antibody in serum is the prerequisite to ensure safe blood transfusion and avoid related diseases.
Blood group plays an important role in the field of human genetics. The blood type of parents determines the blood type of their children. Generally speaking, a person’s blood type remains unchanged all his life, but more and more reports and studies show that human ABO blood type will change temporarily under the influence of some diseases or stress factors. The essence of the so-called blood group change here is the change of blood group antigen, which is most common in some leukemia, a few cancers, infections Newborns, the elderly and patients with cachexia.
The blood group variation in these diseases is temporary and incomplete, and can return to normal when the condition improves. The dynamic observation of blood group variation can explain the aggravation and remission of the condition. In patients with solid tumors and hematological diseases, a and B antigens weaken or disappear during treatment, or even blood group variation, resulting in certain difficulties in blood transfusion. Laboratory serological examination should be strengthened to ensure homotype transfusion.
There is also a way of blood group variation, which belongs to long-term or even permanent variation. When the patient’s hematopoietic function is weakened and destroyed, it indicates that there is a problem with hematopoietic stem cells in his bone marrow. After transplanting other people’s bone marrow hematopoietic stem cells, the patient’s (recipient’s) blood type may change. Although this situation is only a very small population compared with the vast majority of people, a considerable number of recipients at home and abroad have changed their red cell blood type to donor red cell blood type after bone marrow transplantation. Researchers from the Institute of Hematology, Chinese Academy of Medical Sciences and the hospital of Hematology have discussed the blood group variation and corresponding blood transfusion methods of 30 patients after stem cell transplantation.
Because the transplantation of bone marrow stem cells in patients is mainly carried out by human leukocyte antigen (HLA) matching, ABO blood group incompatibility between recipients and donors can also be transplanted. After bone marrow transplantation, the patient’s own hematopoietic stem cell function gradually degenerates, resulting in complete loss of function, and its red blood cells continue to decline. The transplanted donor stem cells replace the hematopoietic function. The newly generated blood red blood cells and white blood cells become the main components in the recipient’s blood. Of course, the antigen on the red blood cells has changed and become the antigen of the donor. Secondly, the original antibody (serum lectin) in the recipient’s serum is also gradually disappearing, so the patient’s blood group gradually becomes the donor’s blood group. In this case, the recipient’s hematopoietic function is completely or mostly replaced by the transplanted donor’s bone marrow stem cells. Therefore, the change of blood group is long-term or even permanent, unless the recipient’s own hematopoietic function is restored and plays a dominant role in hematopoiesis.
Human beings began to explore that blood transfusion should be a reliable treatment method very early, but the process was very difficult and sacrificed many patients. Later, our great Austrian scientists discovered the blood type and explained why some people died after blood transfusion and some people were saved. Blood transfusion developed rapidly. Recently, it has been found that human blood type can be changed under some pathological conditions. Human understanding of science is progressing step by step. I believe that in the near future, mankind will be more perfect in these knowledge.