Medicine: Red, White & Platelets

Every day in countless U.S. hospitals a doctor wants to infuse red blood cells into the veins of an anemic patient. So he takes a pint or more of whole blood and lets it stand. After a while, the red cells (40% of the total) settle to the bottom, along with dead white cells and platelets. A technician draws off the plasma and throws it away. At the same moment, possibly in a hospital across the street, another doctor wants to give plasma to a victim of burns or surgical shock. To save time, he usually gives whole blood, although all he wants is plasma. This way, a Niagara of blood has been wasted, because there has been no practical method of keeping red cells or whole blood more than about three weeks, and keeping plasma is even more difficult.

Like a Washing Machine. Last week blood specialists meeting in Boston heard exciting reports of new ways of handling blood so that all its parts will be as fully utilized as a pig in a packinghouse. Of outstanding importance was the news about red cells. There are 5,000,000 or more of these (each about one four-thousandths in. in diameter) in a cubic-millimeter droplet of blood. It has always been easy to separate them, and recently a method of freezing them in glycerin was perfected. The trick is to get them out of the giycerin undamaged, and that has taken hours of complex effort.

Now the job can be done quickly and easily, reported Dr. James Lyman Tullis of Harvard’s Blood Characterization Laboratory. Key to this success is a refinement of the late Edwin J. Cohn’s fractionation machine, which used to fill a 32-ft. trailer (TIME, Oct. 23, 1950) and has now been squeezed down to the size of a dishwasher. This uncanny apparatus has been adapted and taught to wash the glycerin from the red cells without damaging them. With this machine, Dr. Tullis believes, the life of red cells can be extended well beyond two years. So far, only six of the new machines have been built, but as they become generally available, doctors who want red cells will be able simply to goto the freezer for them.

An Icebox Will Do. In preserving the blood’s white cells (twice as big as the red, 7,000 to a cu. mm.), researchers could report no comparable success. But they had at least some good news: they have concentrated the substance (a protein) that stimulates white cells to devour invading bacteria and thus makes them the body’s shock troops against infection. If an injection could whet the white cells’ appetite, it would be a powerful reinforcement of the body’s natural defenses.

More mysterious than the red or white cells are the blood’s tiny platelets (one twenty-five-thousandths in. in diameter, 200,000 to the cu. mm.) Nobody knows quite how they work, but they are essential to blood clotting. When they are absent, as in certain types of leukemia the patient may die from internal bleeding through microscopic holes in the walls of blood vessels. Platelets, it was long feared, were too fragile ever to be preserved. But Dr. Tullis and his colleagues have found that by handling blood in nonwettable plastic vessels, and removing other clotting proteins, platelets can be separated and kept indefinitely at ordinary icebox temperatures.

It will take time to make the platelet-processing technique generally available. But eventually, it will be a strong line of defense for radiation casualties. At Hiroshima, many of the nonviolent deaths were from internal bleeding caused by damage to the victims’ platelets.