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Of Lungs and Leukocytes

Dale E. Hammerschmidt, MD
JAMA. 1980;244(19):2199-2200. doi:10.1001/jama.1980.03310190051025.
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The publication more than three centuries ago of Harvey's De Motu Cardis laid the theoretical foundation for blood transfusion. Early attempts followed soon thereafter and often met with disastrous outcome; even the reports of early "successes" contain vivid description of acute intravascular hemolysis, complete with back pain, fever, confusion, and hemoglobinuria.1 In this century, the major and minor erythrocyte antigens have been recognized and practical techniques for anticoagulation, storage, and compatibility testing of blood have been devised. Once a desperate gamble, blood transfusion has become a safe and routine procedure. But the goal of complete safety remains elusive.

Sensitization to minor RBC antigens may occur in consequence of pregnancy or prior transfusion, occasionally escaping detection in cross matching and resulting in hemolytic transfusion reactions. Our methods for excluding carriers of the hepatitis viruses (A, B, and non-A, non-B) from blood donation are primitive.2 A third problem of particular


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