How do blood transfusions work? - Bill Schutt

Prevodilac: Aleksandar Bošnjak Lektor: Milenka Okuka

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

Godine 1881, doktor Vilijam Halsted žurio je da pomogne svojoj sestri Mini,

who was hemorrhaging after childbirth.

koja je krvarila nakon porođaja.

He quickly inserted a needle into his arm,

Brzo je ubacio iglu u svoju ruku,

withdrew his own blood, and transferred it to her.

izvadio je svoju krv i dao je sestri.

After a few uncertain minutes, she began to recover.

Nakon nekoliko neizvesnih minuta, počela je da se oporavlja.

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

Halsted nije znao koliko su imali sreće.

His transfusion only worked because he and his sister

Njegova transfuzija je uspela samo zato što su on i njegova sestra

happened to have the same blood type—

imali istu krvnu grupu,

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

nešto što nije zagarantovano, čak i među užom rodbinom.

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

Krvne grupe nisu bile otkrivene u Halstedovo vreme,

though people had been experimenting with transfusions for centuries—

iako su ljudi eksperimentisali sa transfuzijama vekovima,

mostly unsuccessfully.

uglavnom bezuspešno.

In 1667, a French physician named Jean-Baptiste Denis

Godine 1667, francuski lekar Žan-Baptist Deni je postao

became the first to try the technique on a human.

prvi koji je pokušao tehniku na ljudskom biću.

Denis transfused sheep’s blood into Antoine Mauroy,

Deni je preneo krv ovce u Antoena Moroa,

a man likely suffering from psychosis,

čoveka koji je verovatno patio od psihoze,

in the hopes that it would reduce his symptoms.

u nadi da će smanjiti njegove simptome.

Afterward, Mauroy was in good spirits.

Nakon toga, Moro je bio raspoložen.

But after a second transfusion, he developed a fever,

Ali nakon druge transfuzije, dobio je temperaturu,

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

jak bol u donjem delu leđa, intenzivno pečenje u ruci

and he urinated a thick, black liquid.

i mokrio je gustu, crnu tečnost.

Though nobody knew it at the time,

Niko nije znao u to vreme, pak,

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

da su ovo bili znaci opasne imune reakcije koja se odvijala unutar njegovog tela.

This immune response starts  with the production of proteins

Ovaj imuni odgovor započinje proizvodnjom proteina

called antibodies,

koji se nazivaju antitelima,

which distinguish the body’s own cells from intruders.

koja prave razliku između ćelija sopstvenog tela i uljeza.

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

To rade tako što prepoznaju strane proteine ili antigene,

embedded in an intruder’s cell membrane.

koji su ugrađeni u ćelijsku membranu uljeza.

Antibodies latch onto the antigens,

Antitela se zakače za antigene,

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

dajući signal ostalim imunim ćelijama da napadnu i unište strane ćelije.

The destroyed cells are flushed from the body in urine.

Uništene ćelije se izbacuju iz tela kroz urin.

In extreme cases, the massive break down of cells

U ekstremnim slučajevima, masovno razlaganje ćelija

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

uzrokuje ugruške u krvnom toku, koji remete tok krvi ka vitalnim organima,

overload the kidneys, and cause organ failure.

preopterećuju bubrege i uzrokuju otkazivanje organa.

Fortunately, Denis’s patient survived the transfusion.

Na sreću, Denijev pacijent je preživeo transfuziju.

But, after other cross-species transfusions proved fatal,

Ali, nakon što su se druge transfuzije između vrsta pokazale fatalnim,

the procedure was outlawed across Europe,

procedura je postala zabranjena duž Evrope

falling out of favor for several centuries.

i nije se koristila nekoliko vekova.

It wasn’t until 1901 that Austrian physician Karl Landsteiner

Sve do 1901. godine kada je austrijski lekar Karl Landštajner

discovered blood types,

otkrio krvne grupe,

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

važan korak ka uspešnoj transfuziji krvi između ljudi.

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

Primetio je da kada se pomešaju različite grupe, one prave ugruške.

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

Ovo se dešava kada se antitela zakače za ćelije sa stranim antigenima,

causing blood cells to clump together.

uzrokujući da se ćelije krvi zgrušaju.

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

Ali, ako su ćelije donora iste krvne grupe kao ćelije primaoca,

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

ćelije donora neće biti uništene i neće se formirati grudvice.

By 1907,

Do 1907. godine,

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

doktori su mešali male količine krvi pre nego što je transfundiraju.

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

Ako nije bilo grudvica, tipovi su se poklapali.

This enabled them to save thousands of lives,

Ovo im je omogućilo da spasu hiljade života,

laying the foundation for modern transfusions.

postavljajući temeljac za moderne transfuzije.

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

Sve do sada, sve transfuzije su se dešavale u sadašnjem vremenu,

directly between two individuals.

direktno između dve individue.

That’s because blood begins to clot almost immediately

To je zato što krv počinje da se zgrušava skoro odmah

after coming into contact with air—

nakon što dođe u kontakt sa vazduhom,

a defense mechanism to prevent excessive blood loss after injury.

a to je odbrambeni mehanizam koji sprečava prekomerno gubljenje krvi nakon povrede.

In 1914, researchers discovered that the chemical sodium citrate

Godine 1914, istraživači su otkrili da hemikalija natrijum citrat

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

zaustavlja koagulaciju krvi otklanjajući kalcijum koji je neophodan za zgrušavanje.

Citrated blood could be stored for later use—

Krv sa citratima može da se sačuva za kasniju upotrebu,

the first step in making large scale blood transfusions possible.

što je prvi korak ka omogućavanju transfuzije krvi u velikim razmerama.

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

Godine 1916, par američkih naučnika je otkrio efektniji antikoagulant

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

nazvan heparin koji deaktivira enzime koji omogućuju zgrušavanje.

We still use heparin today.

I dan-danas koristimo heparin.

At the same time,

U isto vreme,

American and British researchers developed portable machines

američki i britanski istraživači su razvili prenosive mašine

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

koje su mogle da transportuju krv na bojna polja u Prvom svetskom ratu.

Combined with the newly-discovered heparin,

U kombinaciji sa novootkrivenim heprinom,

medics safely stored and preserved liters of blood,

doktori su na siguran način skladištili i čuvali litre krvi,

wheeling it directly onto the battlefield to transfuse wounded soldiers.

prebacujući je direktno na bojno polje da daju krv ranjenim vojnicima.

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

Nakon rata, ova nezgrapna prenosiva kutija postala je inspiracija

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

za današnju banku krvi, i deo je opreme bolnica širom sveta.