How do blood transfusions work? - Bill Schutt

Translator: Aditya Bachtiar Reviewer: Medina Alia

In 1881, doctor William Halsted rushed to help his sister Minnie,

Di tahun 1881, dokter William Halsted bergegas menolong adiknya Minnie,

who was hemorrhaging after childbirth.

yang mengalami pendarahan saat melahirkan.

He quickly inserted a needle into his arm,

Dengan cepat ia memasukkan jarum ke lengannya,

withdrew his own blood, and transferred it to her.

mengambil darah, disalurkannya ke sang adik.

After a few uncertain minutes, she began to recover.

Setelah beberapa saat, ia mulai pulih.

Halsted didn’t know how lucky they’d gotten.

Halsted sangat beruntung.

His transfusion only worked because he and his sister

Transfusinya berhasil karena dia dan sang adik

happened to have the same blood type—

memiliki golongan darah yang sama---

something that isn’t guaranteed, even among close relatives.

sesuatu yang belum pasti terjadi, sekalipun pada saudara dekat.

Blood types hadn’t been discovered by Halsted’s time,

saat itu Haldsted belum mengetahui apa itu golongan darah,

though people had been experimenting with transfusions for centuries—

walau banyak yang sudah bereksperimen dengan transfusi darah selama berabad-abad

mostly unsuccessfully.

kebanyakan mereka gagal.

In 1667, a French physician named Jean-Baptiste Denis

Pada tahun 1667, dokter Prancis bernama Jean-Baptiste Denis

became the first to try the technique on a human.

adalah yang pertama melakukan transfusi darah pada manusia.

Denis transfused sheep’s blood into Antoine Mauroy,

Denis memasukkan darah domba pada tubuh Antoine Mauroy,

a man likely suffering from psychosis,

seorang penderita semacam sakit jiwa,

in the hopes that it would reduce his symptoms.

berharap bisa mengurangi gejalanya.

Afterward, Mauroy was in good spirits.

Kemudian, Mauroy seolah sehat.

But after a second transfusion, he developed a fever,

Namun setelah transfusi kedua, ia mulai demam,

severe pain in his lower back, intense burning in his arm,

sakit hebat di punggung bagian bawah, lengan terasa terbakar,

and he urinated a thick, black liquid.

serta kencing yang kental dan hitam.

Though nobody knew it at the time,

Walau tak ada yang tahu saat itu,

these were the signs of a dangerous immune response unfolding inside his body.

namun sistem pertahanan tubuhnya merespons sebagai tanda bahaya.

This immune response starts  with the production of proteins

Respons pertahanan tubuh dalam bentuk memproduksi protein

called antibodies,

bernama antibodi,

which distinguish the body’s own cells from intruders.

yang dapat mengenali adanya sel-sel asing dari luar badan.

They do so by recognizing the foreign proteins, or antigens,

Terjadi dengan cara mengenali protein asing, atau antigen,

embedded in an intruder’s cell membrane.

yang terdapat pada membran sel asing tersebut.

Antibodies latch onto the antigens,

Antibodi menempel pada antigen,

signaling other immune cells to attack and destroy the foreign cells.

meminta sel imun lain menyerang dan menghancurkan sel asing tersebut.

The destroyed cells are flushed from the body in urine.

Sel-sel hancur tersebut dikeluarkan tubuh lewat air kencing.

In extreme cases, the massive break down of cells

Dalam kondisi parah, sel hancur dalam jumlah banyak

causes clots in the bloodstream that disrupt the flow of blood to vital organs,

menyumbat aliran darah dan mengganggu aliran darah pada organ vital,

overload the kidneys, and cause organ failure.

memenuhi ginjal, dan menyebabkan kegagalan fungsi organ.

Fortunately, Denis’s patient survived the transfusion.

Untungnya, pasien Denis mampu bertahan.

But, after other cross-species transfusions proved fatal,

Namun, saat tranfusi antar-spesies terbukti berbahaya,

the procedure was outlawed across Europe,

proses transfusi dilarang di seluruh Eropa,

falling out of favor for several centuries.

hingga berabad-abad lamanya.

It wasn’t until 1901 that Austrian physician Karl Landsteiner

Hingga pada tahun 1901 dokter Austria bernama Karl Landsteiner

discovered blood types,

menemukan golongan darah,

the crucial step in the success of human to human blood transfusions.

penentu suksesnya transfusi darah antar-manusia.

He noticed that when different types were mixed together, they formed clots.

Dia mengamati golongan darah yang berbeda jika disatukan akan menggumpal.

This happens when antibodies latch on to cells with foreign antigens,

Hal ini terjadi saat antibodi menempel pada antigen sel asing.

causing blood cells to clump together.

membuat sel darah saling menggumpal.

But if the donor cells are the same blood type as the recipient’s cells,

Saat sel dari donor bergolongan sama dengan golongan darah penerima,

the donor cells won’t be flagged for destruction, and won’t form clumps.

sel darah tidak akan dianggap ancaman, dan tidak akan menggumpal.

By 1907,

Hingga tahun 1907,

doctors were mixing together small amounts of blood before transfusing it.

dokter mencampur sedikit sampel darah sebelum proses transfusi.

If there were no clumps, the types were a match.

jika tidak menggumpal, berarti jenis darahnya sama.

This enabled them to save thousands of lives,

Memungkinkan mereka bisa menyelamatkan ribuan nyawa,

laying the foundation for modern transfusions.

sebagai dasar pengetahuan transfusi modern.

Up to this point, all transfusions had occurred in real time,

Di titik ini, transfusi dilakukan pada satu waktu,

directly between two individuals.

secara langsung antar individu.

That’s because blood begins to clot almost immediately

Karena darah bisa segera menggumpal

after coming into contact with air—

saat terpapar dengan udara---

a defense mechanism to prevent excessive blood loss after injury.

upaya melindungi dari pendarahan saat terjadi luka.

In 1914, researchers discovered that the chemical sodium citrate

Pada tahun 1914 peneliti menemukan bahwa penggunaan sodium sitrat

stopped blood coagulating by removing the calcium necessary for clot formation.

mencegah pembekuan darah dengan membuang kalsium penyebab gumpalan.

Citrated blood could be stored for later use—

Dengan demikian darah dapat disimpan lebih lama---

the first step in making large scale blood transfusions possible.

langkah pertama yang memungkinkan transfusi darah skala lebih besar.

In 1916, a pair of American scientists found an even more effective anticoagulant

Pada 1916, dua peneliti Amerika menemukan anti-gumpal yang lebih efektif

called heparin, which works by deactivating enzymes that enable clotting.

disebut heparin, bekerja dengan cara mematikan fungsi enzim pembeku.

We still use heparin today.

Heparin masih digunakan hingga sekarang.

At the same time,

Pada saat yang sama,

American and British researchers developed portable machines

Peneliti Amerika dan Inggris mengembangkan penyimpanan portabel

that could transport donor blood onto the battlefields of World War I.

untuk mengangkut donor darah ke medan tempur Perang Dunia I.

Combined with the newly-discovered heparin,

Menggabungkan temuan baru bernama Heparin,

medics safely stored and preserved liters of blood,

tenaga kesehatan dapat menyimpan darah dengan banyak dan aman,

wheeling it directly onto the battlefield to transfuse wounded soldiers.

diangkut langsung ke medan tempur ditransfusikan pada tentara yang terluka.

After the war, this crude portable box would become the inspiration

Setelah perang, kotak penyimpanan sederhana tersebut menjadi inspirasi

for the modern-day blood bank, a fixture of hospitals around the world.

untuk bank darah di era modern, di tiap-tiap rumah sakit seluruh dunia.