Current progress in developing ‘universal’ red cell products: a review

With the discovery of the A, B and O blood groups and their associated antibodies by Landsteiner in 1900–1901,^1,2 and of group AB by von Decastello and Sturli³ in 1902, it became clear why not all donor blood could be tolerated by all recipients.

It was not until 1911, however, when Ottenburg⁴ described a method of cross-matching blood (mixing the blood of the donor and recipient in glass bottles, warming and leaving the red cells to settle, and then examining the serum for haemolysis and the red cells for gross agglutination) that transfusion became somewhat safer than the lottery that had gone before.  Even so, this method of cross-matching did not find universal approval, and it was some time before it ‘caught on’.

In terms of the prevention of acute (and delayed) haemolytic transfusion reactions, perhaps the next major step forward was the description of the indirect antiglobulin test by Coombs, Mourant and Race in 1945^5,6 (although it was later found that the principle of the test had already been described by Moreschi⁷ in 1908, while working on the vegetable alkaloid ricin).  Sadly, however, this has not proved to be the panacea for the prevention of such reactions.  There are still many reports (including early SHOT reports) of haemolytic transfusion reactions causing morbidity and mortality.^8–25