Frozen for Transfusion

Just because a patient is losing whole blood does not necessarily mean that whole blood is what he should get in replacement. Yet, because of difficulties in collecting blood, separating it into its component fractions and then storing them, whole blood is what he gets in 97% of the millions of transfusions performed annually in the U.S. This is not only wasteful: it is no longer nec essary. Whereas the red cells in whole blood previously would not keep for more than 21 days, they can now be frozen and stored indefinitely. So can other blood components.

One of the leaders in developing the new techniques is the New York Blood Center. The process begins the minute that the blood is donated to the center. Tubes of sample blood go to the laboratory for high-speed analysis and typing. Centrifuges separate out various blood components; the red cells, with glycerol added to prevent ice-crystal formation, are flash-frozen in liquid nitrogen at --320DEG F. Stored at this same temperature in thin stainless-steel flasks, they will keep for years. Says the center's Biochemist Arthur W. Rowe, who developed the technique: "We have taken a long step toward ending the tyranny of the 21 days."

Through the Sidewalk. Also spun out by centrifugation are platelets, the tiny disks involved in clotting. There is still no effective way to prolong their useful life beyond four to six hours, says the center's Dr. Fred H. Allen Jr. So, as soon as they are extracted, the center rushes them to nearby hospitals, notably Manhattan's Memorial Sloan-Kettering Cancer Center, where there are always patients whose platelet count has been cut dangerously low by the drugs needed to treat their leukemia. Still other clotting factors, such as those needed by hemophilia victims, are precipitated out and kept frozen. For a few rare cases, white blood cells are also extracted.

The New York center's program has succeeded to the extent that now, in the city's leading hospitals, up to 70% of transfusions are in the form of fractions. The center already keeps in stock, on the average, several hundred units of whole blood, up to 1,000 of frozen red cells and up to 1,500 of clotting factors. When the center completes its frozen-storage space, for which liquid nitrogen will be delivered like fuel oil through a sidewalk hose hole, it expects to keep regularly on hand 10,000 units of various kinds.

Most important, the red-cell units will include up to 1,000 rare types, a call for which often touches off a transcontinental alarm to round up donors. Dr. Allen points to a corkboard listing the rarest of the 500 types now in stock. A Philadelphia doctor recently phoned the center and asked, not too hopefully, whether it could find donors with an extremely rare blood type. "I don't know about donors," replied the center's duty officer. "Just tell me how many units you want." The doctor wanted eight. He got them.

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