What is Direct blood transfusion?

The surgical removal of some of a patient’s blood for therapeutic purposes was practiced for a wide variety of conditions from the 5th century BC, but transfusion blood from a human into another was not documented until 1818.  Blood transfusions are a therapeutic measure used to restore blood or plasma volume after extensive hemorrhage, burns, or trauma; to increase the number and concentration of red blood cells in persons with anemia in order to improve the oxygen-carrying capacity of their blood; and to treat shock. 

Direct transfusion the blood flowing directly from an artery of the donor into the patient’s veins. The obvious method of performing a direct transfusion is by making an end-to-end anastomosis between an artery of the donor and a vein of the recipient.

If direct transfusion be desired, there can be no doubt that Crile’s method, introduced some fifteen years ago, is the best to employ. After much patient work Crile perfected a method of anastomosis which ensures that no occlusion of the vessels can take place at the site of junction. This depends on the use of a short silver tube, through which the end, of the artery is threaded. The artery is then pulled back again outside the tube in the form of a cuff and fixed in position. The end of the artery has thus been made rigid, and over this the vein is pulled in its turn and fixed by a ligature. A watertight junction is thus made, and blood can flow through it without interruption unless clotting takes place in the vessels as the result of handling and injury to their walls. This method has been extensively used in America, and it was the first to render the operation of transfusion a comparatively popular one.

It can easily be seen, therefore, that all the known methods of direct blood transfusion present great technical difficulty, which renders the method unsuitable for general use because:

1- Impossible to measure the amount of blood which has passed from the donor to the recipient. 2- The extent of the injury which is necessarily inflicted on the donor. His radial artery must be exposed through an incision of considerable length, and must be ligatured at the conclusion of the process.

 3- The transfusion cannot be done with due regard to the condition of the patient. A delicate and difficult operation has to be performed with the donor and recipient lying side by side, their arms close together.   

4- In some people the, radial artery is of very small caliber, so that when all preparations have been made, and the artery exposed, it is found to be quite impossible to proceed.

There is, therefore, little to be said in favor of direct transfusion, and much to be urged against it. This method not possible until now.