Transfusion medicine: Historical background and the legislation

Abstract

Introduction: More than 300 years have passed from the first attempts to use blood for therapeutic purposes, to scientifically based postulates of blood use. Each generation of physicians, faced with the need for clinical transfusions to save lives, has contributed to the safety and acceptance of transfusions by tackling the lack of laboratory equipment, legislation and even adequately trained medical staff. To indicate the existing regulations for a significant clinical area of Clinical transfusion medicine as a separate entity. Material and Methods: Online search of the historical and medical development of trans - fusion and international and domestic regulations in the field of transfusion medicine. A literature search was conducted using PubMed, Cochrane, Embase, and Scopus databases. The search was done on the following keywords: transfusion medicine, regulative, doc - tor's education, history of transfusion . Topic: The first successful human-to-human transfusion directly from vein to vein was performed in 1818 by the English physician Dr. James Blundell. As blood groups were not known at the time, this transfusion was successful by chance. In 1901, the Austrian doc - tor Dr. Karl Landsteiner discovered the ABO blod group system, so the transfusion became safer. Over the decades, the blood establishment has been improved both organizationally and functionally in order to ensure the safest possible blood. Blood banks in 1970's move to - ward an all-volunteer blood donor system. The turning point for the organization of hos - pital blood banks was 1987, when the European directive provided for the gathering of member states on the legal responsibility for blood products, starting in July 1988. A "Safe Blood Strategy" is being developed on the basis of WHO guidelines. On the basis of Article 152 of the Amsterdam Treaty of 1999 and the amendment of Directive 2001/83/ EC - EP and EC, Directive 2002/98/EU of the European Parliament and of the Council 2003 was created. So far, 8 editions of the guidelines "Red Book" have been published. Based on international guides and standards, it can be said that the clinical transfusion of the Republic of Serbia has developed in parallel with world trends. The European Commission operates through recommendations (EC recommendations), of which the most important in practice are: Recommendation No.R (88) 4 concerning the responsibility of health authorities in the field of blood transfusion. Modern therapeutic procedures include vigilance system which is why it was formed Euro - pean Haemovigilance Network (EHN) in 1998, from which the International Haemovigilance Network was formed later in 2009 (IHN). Conclusion: The therapeutic shift towards personalized therapy, including therapeutic cells, "patient blood management", has a future development in teamwork and interdisciplinary cooperation with clinical pharmacologists, immunologists, toxicologists, hematologists, obstetricians, surgeons, pediatricians. It is obligatory to acquaint all health profiles with the regulations from clinical transfusion medicine.