UVOD V TRANSFUZIJSKO MEDICINO - 10 Kratka zgodovina transfuzije Jean-BaptisteDenis 1640 -1704...

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Transcript of UVOD V TRANSFUZIJSKO MEDICINO - 10 Kratka zgodovina transfuzije Jean-BaptisteDenis 1640 -1704...

  • Primož Rožman

    2006

    UVOD V TRANSFUZIJSKO UVOD V TRANSFUZIJSKO MEDICINOMEDICINO

  • 22

    VsebinaVsebina

    Kratka zgodovina transfuzije1

    Transfuzijska medicina v Sloveniji2

    3 Organizacija transfuzijske dejavnosti

    4 Transfuzija kod veda, znanost

    5

    6

    7

    Prihodnost transfuzije

    Mednarodna združenja

    K-skladna transfuzija

  • 33

    “Blut ist ein ganz besonderer Saft”

    Johann Wolfgang von Goethe, FAUST

    1749-1832

  • 44

    Kri je edini tekoči organ Vsebuje številne vrste celic Brez krvi ni življenja Oskrbuje vsako človeško celico:

    – Hranivo – Kisik – Energija – Toplota – Izmenjava snovi

    Ima sposobnost hemostaze Vsebuje informacije o drugih organih Ali je že na razpolago umetna kri?

    To drži, kajti:

  • 55

  • 66

    Huang Di Nei Jing - Yellow Emperor’s Classic

    of Medicine, China, Warring States period,

    475-221 B. C.

    “The flow of blood . . never stops . . . . . it is moving eternally . . . . in a closed circle . “

    Chi Poh, Court doctor

    Huang Di (2698 - 2589 B.C.)

  • 77

    1492: First reported historical attempt at a blood transfusion:

    the Pope Innocent VIII sank into a coma, at the suggestion of a Jewish physician, the blood of three boys was infused into his veins. They were ten years old, and had been promised a ducat each. All three died.

  • 88

    1628: William Harvey

  • 99

    1667 Jean-Baptiste Denis, a physician to Louis XIV : the first transfusion from a sheep to a madman. The patient died, Denis accused of murder, Blood transfusion banned by for 150 years.

    1666 Richard Lower:

    direct transfusion dog-dog: “The dog came back from the dead, as though the life force had filled it up again."

  • 1010

    Kratka zgodovina transfuzije

    Jean-Baptiste Denis 1640 - 1704

    Transfuzija prepovedana

    Pariška medicinska fakulteta

    1688

    transfuzija živalske krvi človeku 1667

    James Blundell* 1770-1878

    Transfuzija krvi s človeka na človeka

    2000

    Karl Landsteiner 1868-1943

    Odkrije ABO in (skupaj z Levinom) Rh sistem

    PREPOVED VELJA 130 LET!

    Prvo uspešno ABO – skladno transfuzijo - V bolnišnici Mt. Sinai izvede Dr. Reuben

    Ottenberg

    19071818

    *Sklicuje se na Leacockovo delo na Karibih

  • 1111

    Dr.James Blundell, a British obstetrician: the first successful transfusion human-patient for the treatment of postpartum hemorrhage. He used the patient's husband as a donor, extracted 4 ounces of blood from his arm to transfuse into his wife.

    1825 – 1830: he performed 10 transfusions, 5 beneficial and published

    1818

  • 1212

    Uvod dr. James Blundell, 1825Uvod dr. James Blundell, 1825--18301830

    performed 10 transfusions, 5 beneficial and published

  • 1313

    MILESTONES OF TM IN 20th cent.

    1900 : Landsteiner AB0 blood groups 1909: Ottenberg - crossmatch 1914: Albert Hustin, BE, non-direct transfusion with Na-citrate 1916: Royal Army Medical Corps: cooled stored blood 1925: blood transfusion institute, Alexander Bogdanov - Moscow 1940: Landsteiner, Wiener - Rh blood groups 1945: Coombs et al. - antiglobulin test (Moreschi 1908) 1964: Terasaki - microcytotoxicity test, HLA typing 1990s: - molecular typing 2000s: - cellular therapies

  • 1414

    1901: Institute of Pathology and Anatomy, Vienna. Prof. Dr. Anton Weichselbaum. Assist. Dr. Karel Landsteiner

    Tabelle 1. betrettend das Blut sechs anscheinend gesunder Manner

    Sera/RBCs Blood group

    Dr. Stork - + + + + - C Dr. Plečnik - - + + - - B Dr. Sturli - + - - + - A Dr. Erdheim - + - - + - A lab. Carič - - + + - - B Dr. Landst. - + + + + - C

    Odkritje krvnih skupin ABOOdkritje krvnih skupin ABO

  • 1515

    dr.Karl Landsteinerdr.Karl Landsteiner

  • 1616

    Janez Plečnik Janez Plečnik (1875 (1875 -- 1940)1940)

  • 1717

    Predtransfuzijske preiskave - laboratorij

  • 1818

    Predtransfuzijske preiskave

    1933 dr.F. Oehlecker: „biološki preiskus”

    = in vivo crossmatch

  • 1919

  • 2020

    direktna transfuzijadirektna transfuzija

  • 2121

    Predtransfuzijske preiskave

    1909: v bolnišnici Mount Sinai Hospital, New York - izvede dr. Reuben Ottenberg prvo uspešno ABO – skladno transfuzijo navzkrižni preiskus

    1882-1959

  • 2222

    PretransfusionPretransfusion TestingTesting

    ● 1939/40: RhD kompatibilnost

    ● 1946 → antiglobulinski (Coombsov test)

  • 2323

  • 2424

  • 2525

    Slovenska transfuzijska medicina

    1926: prva transfuzija krvi v Mariboru, dr. A.Ramšak 1945: Oddelek za transfuzijo krvi v Centralni vojni bolnici - organizacija krvodajalstva, odvzemanje in konzerviranje krvi, 1946: Zavod za transfuzijo krvi MF v Ljubljani 1956: Zavod RS za transfuzijo krvi 1949 – 1959: transfuzijski oddelki v CE, MB, Izoli, MS, Ptuju, SG, NG, NM in Trbovljah

  • 2626

    TRANSFUZIJSKA VERIGA

    DAJALEC

    KRVNA BANKA

    BOLNIK

    ODVZEM

    PREDELAVA

    TESTIRANJE

    APLIKACIJA

  • 2727

    5 Collection Issuing & crossmatching Processing Testing

    2 4

    8,980

    41,029

    312

    11,414

    4,457

    4,240

    4,179

    2,914

    2,776

    1,409

    4,769

    Trbovlje

    Ptuj

    Ljubljana

    Organization of Blood transfusion service in Slovenia - 2004

  • 2828

    Blood Donors Structure in Slovenia

    Sex: female male

    Age:

    Frequency of blood donation

    4 x2 %

    3 x7 %

    2 x29 %

    1 x62 %

    per yearblood donors

  • 2929

    94,935 1070 sessions

    83 694 units 33 951 units

    1 394 units 27 991 litres

    blood donors (4.75% of population) (323 at the field collection sites) red blood cells platelets (recovered from whole blood) platelets (platelet apheresis) plasma (recovered from whole blood + collected by plasmapheresis)

    Statistics for the Year 2004

    Percentage of collected whole blood

  • 3030

    TRANSFUZIJSKA MEDICINA KOT MEDICINSKA VEDA

    združuje klinične in temeljne medicinske vede Področja:

    biologija krvi, fiziologija, imunologija, imunohematologija in imunogenetika, celične terapija medicinska biotehnologija, itd.

  • 3131

    TRANSFUZIJSKA MEDICINA KOT STROKA

    1. preskrba s krvjo – krvodajalstvo, blood banking 2. zdravljenje s krvjo in krvnimi pripravki - klinična TM 3. transplantacija, histokompatibilnost 4. zdravljenje z drugimi postopki – biotehnologija, celična TH 5. laboratorijske preiskave, ki podpirajo TM 6. spremljevalne aktivnosti:

    nacionalni register krvodajalcev, bolnikov, dajalcev kostnega mozga biobanka razvoj transfuzijske informacijske tehnologije prenatalna zaščita

  • 3232

    TM KOT ZNANOST

    Influence of 3D carriers on differentiation capabilities of chondrocytesL7-7598 The use of cultivated skin supplements for the treatment of chronic and acute woundsL7-7457 Development of tissue engineered bone for use in periodontology, traumatology and orthopaedic surgeryL4-6325 Isolation, characterisation and differentiation of human stem cell as a basis for cellular therapyL3-6011 Prion diseases and their diagnosticsL3-6006 The use of cultivated autologous chondrocytes for ttreatment of vesico-uretheral refluxL3-6265 Prion diseases and their diagnosticsL3-3435 Immunomodulation in solid malignant tumors refractory to standard treatmentL3-3368 Human Monocyte Derived Dendritic Cells - The Activators and Modulators of Specific Immune ResponsesL1-6295

    The production of human recombinant metalloproteinase inhibitor TIMP-1 and development of specific immunodiagnostic reagents for determination of the native TIMP-1 in biological samples.L1-3372

    Pharmakogenetics of thiopurines- diagnostics and individualized therapyJ3-7406 Healing of poorly healing fractures of long bone with the use of platelet rich plasmaJ3-6290 Genetic background of chronic diseases in children and adolescentsJ3-6072 Genetic mechanisms of human diseasesJ3-4532 Molecular-genetic basis of chronic disorders in children and adolescentsJ3-3096 Chemical and biological monitoring of neonicotinoids and their impact assessment in the environmentJ1-6001

  • 3333

    TM V IZOBRAŽEVANJU

    Dodiplomski programi: • Medicinska fakulteta

    •Katedra za ginekologijo/porodništvo V letnik •Katedra za interno medicino VI letnik

    • Visoka šola za zdravstvo - Program za VMS – 2.letnik • Fakulteta za farmacijo: Laboratorijska biomedicina, Visoki študij 3+2. Predmet: Hematologija s transfuzijsko medicino, 2.letnik

    Podiplomski programi: • Medicinska fakulteta

    •Smer Biomedicina, izbirni predmet: Transfuzijska medicina, transplantacija in celična terapija

    • Fakulteta za farmacijo: Predmet Laboratorijska transfuzijska