Blood, Organ, and Tissue Banks

blood, organs, and tissues stored outside the body in a state of full physiological effectiveness and suitability for practical use. Banking makes it possible to have blood, organs, and tissues prepared in advance, always in reserve, and transportable over considerable distances.

Both organs (skin, bones, blood vessels, testes, kidneys, spleen, bone marrow, thyroid) and tissues (cartilage, fascies, dura mater, cornea, pericardium) are banked, taken from donors and preserved in special media under special temperature conditions. This is done by refrigeration (to temperatures from 0° to 4°C); by freezing (to −25° or −30°C), which may be quick and deep (to −70° or −96°C) or ultrafast (to −183° or −196°C); or by drying the tissues under a vacuum (lyophilization).

Gaseous (carbon dioxide), solid (sterile paraffin, plastic), and liquid media can also be used. The liquid chemical media used include physiological and hypertonic solutions, simple disinfect-ants (weak solutions of carbolic acid, chloramine, formalin), compound media (”T” solution with peptone; solutions No. 21 and No. 85 with monosaccharides and disaccharides; cryotolerant Beliakov’s media; “gelatinol” solution; Hanks’ media; medium No. 199). The liquid biological media include blood, plasma, and ascitic fluid. Many of the preservatives comprise nutritive substances, antibiotics, and antihistamines (diprazin, Mycerin, Phenergan, ethyzine) that inhibit the histolysis of the tissues and the formation of histamines, which have a negative effect on the desired processes.

The storage periods for organs and tissues depend on the properties of the preserved organs or tissues and on the method of preservation. In sterile paraffin, the storage periods for various objects is from one to four months, and in some fluid media, from 20 days to a year (for example, bone in an 0.5 percent solution of formalin in physiological solution at 2° to 4°C).

The collection, preservation, and distribution of all biological objects (except blood and its derivatives) is handled by tissue banks consisting of independent laboratories. The tissue banks also develop preservation methods and conduct other scientific research. After being prepared, the organs and tissues are packaged in sterile containers. This makes it possible to transport them subsequently to medical institutions. The preservation of organs and tissues is of tremendous significance for the successful development of transplant surgery.

The banking of blood makes the broad use of transfusion possible, since it makes whole blood, erythrocytes, leukocytes, and thrombocytes, prepared in advance in unlimited quantities, available at all times. The idea of using blood prepared in advance for emergency transfusion was first suggested in 1865 by the Russian physician V. V. Sutugin, who substantiated his concept with experiments on animals. However, the realization of the idea in medical practice became possible only with the discovery of substances to prevent the rapid coagulation of the blood outside the circulatory system. Among these substances, sodium citrate came to be used most widely, and it was introduced into medical practice in all countries of the world.

The foundation in the search for effective methods of preserving the blood and its formed elements is research on the characteristics of the metabolism and of the morphological and physicochemical structures of the erythrocytes, leukocytes, and thrombocytes. Since the viability of erythrocytes (the principal mass of the blood) is maintained chiefly by carbohydrate-phosphorus metabolism, the substrates of which are glucose and phosphate components, appropriate preservatives have been developed to be added in the necessary quantities to the blood. These additives make it possible to store the blood at 4°C for as much as three or four weeks in a condition suitable for transfusion. Further storage at a positive temperature brings about the gradual destruction of the cells, the result of exhaustion of the enzyme systems that maintain the metabolism.

Thanks to progress in cryobiology, effective methods have been developed for the long-term storage of blood (eight to ten years) in deep cold (−79°, −196°C). Storage by freezing (while maintaining the viability and physiological effectiveness of the blood cells) depends on the suspension of the metabolic processes of the cells at ultralow temperatures (anabiosis). Special solutions containing cryophylactic substances (for example, glycerin) have been developed that shield the cells from the destruction that would otherwise occur during freezing. The long-term storage of frozen blood is exceptionally important, since only this makes it possible to build reserves of blood and blood components (especially of the rarer groups).