Credited to Argentina. Sodium citrate as a transfusion anticoagulant was introduced independently in 1914 and 1915 by Albert Hustin in Belgium, Luis Agote in Argentina and Richard Lewisohn in New York. Argentina's claim rests on Agote's transfusion of November 9, 1914.
How it began
Luis Agote, an Argentine physician and researcher, carried out a transfusion of blood treated with sodium citrate at the Rawson Hospital in Buenos Aires in 1914. A historical note in the journal Transfusion records that on November 9, 1914, in the hospital's medical clinic, he transfused 300 mL of citrated blood. Historians of medicine note that the same anticoagulant was introduced independently in 1914 and 1915 by Albert Hustin in Belgium and Richard Lewisohn in New York.
Before it existed
Around 1900 a transfusion usually meant connecting the blood vessels of donor and recipient, first with rubber tubing and later by suturing vessels together. These direct methods required cutting through the skin, great surgical skill and two to three hours, with donor and patient lying side by side. Nobody could measure how much blood passed, and clotting clogged the equipment. Blood could not be stored and had to be given at once.
How it works
Blood clots soon after it leaves the body. Adding sodium citrate to the collected blood prevents coagulation outside the body, so the blood stays liquid in a container. It can then be given to the patient through a needle some time after it was drawn, instead of flowing directly from one person's vessels into another's. The donor and the recipient no longer need to be in the same room.
What changed first
The anticoagulant allowed blood to be kept for a few days. During the First World War citrated blood drawn into glass bottles was collected in advance of need, and it became the method of choice for most Allied medical forces. The Argentine government states that the technique was adopted in Europe and the United States during the war. A single officer with one assistant could give blood at the bedside.
What lasted
Citrated blood made stockpiling possible and led to what many consider the first blood bank, set up on the Western Front in 1917. Doctors who returned from the war brought transfusion into civilian practice. In Argentina, November 9 has been observed since 2004 as the National Day of the Voluntary Blood Donor in memory of Agote's transfusion.
