Current Affairs

Long pursuit of artificial blood


All this excitement reached a sudden end, during the winter of 1667, Dennis began to transport the blood of the calf to a thirty -four -year -old servant named Antoine Mauroy, who was under “phrases” during which he would strike his wife, took off all his clothes, and running in Paris Satisfy houses on fire. Dennis expressed his hope that the blood will be from the gentle calf as a kind of calm, which calms the turbulent Morois. After the first couple of injection, MAUROY sweat, vomiting, and complained about the lower back pain, black coal, all that, we know now, the symptoms of a severe reaction to the transmission of blood in which the antibodies to the recipient are trying to destroy the newly-made foreign material. However, soon he did not recover, but he seemed to be a changing man, talking clearly, whistling cheerfully, and deals with his wife with unprecedented tenderness. Unfortunately, two months later, just as the third transfer was about to leave, he died. Doubt fell to his wife, who claimed that she had placed arsenic in Mauroy’s soup, but the damage had occurred: a long time ago, the French authorities had officially banned the transfusion of blood in humans, with the British government and the Pope after the example shortly after that.

It took more than a century until medicine returns to this technique, and this time as a way to replace lost blood during childbirth. Gradually, blood transfusion has become to look at life-sometimes almost luminous-in narrow cases of injuries and bleeding. “Hopes did not have been there in the past,” as Jeffrey Keynes, the surgeon of the economist John Mainard, put in his memoirs, remembering how, during the First World War, “stealing to the Morbond wing,“ perform blood transfusion to one of the patients, and withdraw. ” Many men again of death jaw. “

However, death was still a frequent consequence of transportation, and not only some of the most important problems in the twentieth century were settled. In the year 1900, the Nobel Prize -winning blood discovery discovered the possibility of survival. The serious blood transfusion reactions are no longer the issue of luck. However, the blood of clotting, very useful in the body, has proven a challenge outside it: within a few minutes of the start of blood transfusion, clots raise needles and tubes, which seriously reduces the amount of blood that can be transmitted from a person to a person. At the age of nineties, a doctor at Mount Sinai Hospital in New York discovered that adding a small amount of sodium jackets to the donor blood was as a matter, “it was as if the sun had been made to stand steadfast.” Then, there was a storage problem.

Dr. Alan told me: “People forget that blood is alive.” “They think it is like urine or something like that. It is a physical liquid – but it is live cells.” Keeping these cells alive outside the body requires very special cases, and through the twenty ninety, blood transfusion requires a direct donor. In London, Jeffrey Keynes relied on the volunteer guide when calling; At a time when many people had a phone, police and priests are often recruited to track the donors at any hour of the day. It was not even the Spanish civil war in 1936 that the Canadian surgeon discovered how to keep the blood of the blood for up to a week, cooled in glass milk bottles, and recently began the era of modern blood transfusion.

In Filton, one of the suburbs on the northern edge of Bristol, the British national health service runs a blood factory that can get up to three thousand units a day. Inside the vast white manufacturing hall, bags and blood bags hanging from the blood, hanging from the steel railways like Macabre jewelry. “They will usually come,” Naomi Jones, the then vice president of the center, who was wearing blue hair clothes. Fresh blood is slightly separated during its hanging: dark red cells, heavy due to their iron content, flooding to the bottom and plasma, which make up more than half of the blood volume, at the top. Both different bags told me in ways, as Jones told me, the donor’s health-some of them had more or less red cells, while the plasma ranged in the shade from lemon juice to Coca-Cola. She said: “If you are on birth control pills or anything like that, the hormones will make them green.” “And people who have a lot of fat in their blood, it’s like banana milk.”

During the blood of blood on the shelf, white blood cells are filtered. After that, in the dedicated pods that a person or two people work, the bags are divided into the rest of their components, which are weighed, described, and placed on the transport belts that transport them to storage. Red blood cells are accumulated in plastic boxes in the refrigerator, separated by the type of blood; Plasma freezing the explosion. The platelets, which must remain in a nice movement, are extracted from the thin beige layers between them, assembled together, and put them on metal shelves inside an incubator leaking from side to side.

It turns out that modern blood is on demand, is a logistical miracle: rubber tubes and milk bottles have been replaced by a designer process that collects the liquid, and tested it, then store each of its elements for the maximum validity process, before obtaining it for the patients who need it. But not all of them. Despite the high productivity of the NHSBT blood factory, and although the blood unit is transported every two seconds in the United States, there is not enough.

Part of the problem is that many people need it. An amazing number of civilians dies every year – corresponding to one hundred and fifty thousand in the United States, and more than five million worldwide. “Every year!” John Holkumb, shock surgeon, said. “It is the main reason for the lost years.” An accidental infection is the main cause of death for any person, forty, or less, and blood loss is the most common cause of traumatic deaths. Holcomb and his colleagues estimate that in the United States alone, there are likely to be thirty thousand cases of prevention that can be prevented every year, due to bleeding. In one of the papers, they combed through the 2014 death data for the province that includes Houston, Texas: Even in a major urban area with a good resource shock sponsorship network, more than one of every three people died from the bleeding can be saved.

“If you go to the hemorrhoid shock, you need blood products,” said Holkumpe. “The data is clear that the more you get blood products, the better your survival.” Each minute is perfectly important, with blood injured individuals on the street or an ambulance, before they arrive at the hospital. Many of them are not, for demographic, biological and economic reasons. “No. 1, there is not enough blood.” “You may need sixty to one hundred thousand units of blood available in the country.” In the UK, NHSBT aims to obtain supplies from five to seven days; In the United States, the goal is similar. The fact is that the blood is sometimes not available. Ghevart told me that, on a last trip to the United States, it was informed that, on that particular day, the platelets were not left at 11 o’clock I am In the New Orleans region. It is blood platelets that allow blood to clot – it saves lifetime for patients who suffer from hemorrhage after surgery, painful injury or birth.

This deficiency is the result of the fact that a few people give blood. Of the thirty -eight percent of the Americans who are qualified to donate, less than three percent. (Some shock experts suggest that re -submitting payment for blood donations, which are currently voluntary, will enhance the offer, although the United States has a harsh history of these arrangements that lead to the exploitation of the poor.) In addition to those bad things, Our residents explained by Philip Spinella, an expert in blood transfusion at the University of Pittsburgh and a co -founder of Kalocyte, the company that develops Erythromer. An increasingly elderly woman, which presses the blood supply of two directions. Mark Gladwin, Dean of the University of Maryland, said, “Our young generation does not donate blood.” Meanwhile, people over the age of sixty-five “develop cancer and a heart surgery-need platelets and red cells,” Spinella continued. “Where will it come from, at the present time, the donor base cannot support today’s needs. What about 2030?”

Fungal blood shift exacerbates this crisis. It has a remarkable short life: five days for platelets, and forty -two for red blood cells. If you add Cryoprotectant, the red blood cells can be successfully frozen – but they should be ignored, and the freezing should be washed with great care, so that the cells do not damage. This can delay the process for hours, and during that time most patients will end. What is more, even the stored blood accurately dies gradually. “When you put the fish in the fridge and leave it for five days, this is less good,” said Holkumpe. “The blood is the same.” The doctor showed me research that measures the amount of red blood cells stored cold oxygen that was able to move. “It is due to forty percent of the normal before it is old,” he said.

The rapid blood blood circulation rate, in addition to the equipment required to slow down its decrease, means that its use tends to be limited to large shock centers in the main urban areas – which means that people who are injured away from these resources, whether they are an hour outside Houston or in any Almost a place in the developing world, has a greater opportunity to die from shock. There are ways about this: in Rwanda, the blood is often delivered by drones; In the United States, it can be carried in a snow box on every ambulance or Midfak helicopter. The fact that it is not purely economic.

“The problem here is that there is no practical payment of blood before entering the hospital through insurance and agencies.” “There is nothing that has a greater effect on survival than pre -hospital blood. nothing. However, the main obstacle is not logistics – we have worked through it. Not how to store blood. It is a payment. In our system, if you are not exposed to you, you do not do that. “Spinella, who told me about a trial in Pittsburg, indicates that the plasma before entering the hospital has greatly improved the survival rates, and that anger. He said:” We had to stop it after the trial ended because our EMS system cannot The blood is placed on ambulances. ”So we have proven it, and now we cannot do this, because it cannot be tolerated. He is a criminal. “

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