52 Books a Year: #51 - Blood

Posted by Brian Wed, 30 Dec 2009 18:09:28 GMT

Blood: An Epic History of Medicine and Commerce
By Douglass Starr

4/5

This was the last of my wife’s popular medical books that she picked up at the library book sale this summer. I ended up reading all of them before she read any. Chronicling the development of blood transfusions from ancient times through today, Blood tells an interesting story. Early transfusion methods and ideas look crude and odd in modern times. For example, early experiments involved transfusing blood from farm animals into patients in an attempt to change their personalities. Needless to say, this didn’t work.

The primary focus in Blood is on two subjects. First, Starr details the rise of the blood industry, mostly beginning with work done during World War II. This was focused on battlefield transfusions and led to the development of technology to separate plasma and to handle blood and its derivative products in bulk. From here the industry exploded, with a number of new blood derivatives entering the market, stretching the number of people who could be treated for each unit of blood given. These developments also led to blood products being combined in large vats of thousands of units, each from a different person, which led to the focus of the rest of the book.

Today the safety of blood transfusions is excellent. It is very rare for anybody to get sick from a blood transfusion, but that wasn’t the case until the 90’s. Before this tens of thousands of Americans contracted hepatitis from transfusions, many because of the large vats used to make derivative products. If one unit of the tens of thousands contains hepatitis the whole vat will be contaminated. This was a known issue for the industry, but there were no tests initially. When tests became available the industry deemed it not cost effective to test every unit. The turning point came when AIDS came on the scene. The clotting that hemophiliacs use is derived from blood products that are pooled into tens of thousands of units. By the 1980s standard hemophiliac treatment involved many injections on a regular basis of this clotting factor, which led to as many as fifty percent of hemophiliacs in some areas contracting AIDS. To compound the problem the industry refused to admit their was a problem, leading to many lawsuits. The details of the industry’s indecision were exposed in court.

Blood leaves the reader with a bad taste in their mouth. Many in the blood industry turned their back on those who were being treated by their products. They either refused to admit their was a problem or decided they couldn’t do anything about it. Many knew that it would effect the bottom line and chose to do nothing. If you are interested in how the blood industry developed, then Blood is an excellent read.

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