Blood from the Dead

The 41-year-old woman in Pontiac General Hospital was anemic and needed blood transfusions to build her up for an operation. From the refrigerator, doctors took a pint of matching (Group A, Rh-positive) blood that had been stored for 19 days and transfused it into one of her veins. By the next day her blood counts were somewhat better, but to be on the safe side, the doctors gave her the concentrated cells from another pint of blood from the same donor.

What made this otherwise routine case remarkable was that the donor was a dead boy of twelve, who had drowned in a nearby lake. After all attempts to revive him had failed, Pathologists Jack Kevorkian and Glenn W. Bylsma did an autopsy and withdrew two pints from a jugular vein. This was 2 1/2 to 3 hours after death. To make sure that no germs had got into the blood (which would make it unsafe for transfusion), samples were incubated for two weeks. The woman patient had no unfavorable reactions to the transfusions of cadaver blood, is now well and at home.

Pathological Prejudice. This was the fourth time that Drs. Kevorkian and Bylsma had supplied cadaver blood for transfusion. In three previous cases the attending physicians tried it cautiously, and only on incurable patients. Yet using cadaver blood is not a new practice. At Moscow's Sklifosovsky Institute, almost 30 tons of it have been given in 30,000 transfusions since the method was first tried there in 1930. U.S. doctors have shied away from it because of prejudice against contact with anything taken from a corpse. The Pontiac pathologists hoped that this prejudice was weakening with wider acceptance of corneal grafting and the transplanting of bone and arteries from accident victims.

Use of cadaver blood offers several advantages. A living donor may lie about his health, especially about such a vital question as whether he has had hepatitis. Moreover, he cannot comfortably give more than a pint every two or three months. The corpse cannot lie, and the pathologists doing an autopsy can check every vital organ for disease--including the liver for evidence of hepatitis. They select as donors only the corpses of presumably healthy individuals who die suddenly, as in traffic accidents or from heart attacks. A cadaver yields far more blood than a walking donor: the Pontiac investigators have drawn as many as three pints from a grown man; the Russians say they get as many as eight pints.

Safety Rules. Drs. Kevorkian and Bylsma thought that they were applying the Russian method for the first time in the U.S. Then they learned, from a recent Bulletin of the American Association of Blood Banks, that as long ago as 1935 Surgeon Leonard L. Charpier had used a similar technique in a Chicago suburb. Dr. Charpier kept the work secret and died without writing up his records. But he was responsible for about 35 cadaver-blood transfusions in two years. Then the modern system of blood banking, which permits blood to be stored for three weeks without deterioration, was developed.

A few strict rules must be followed in using cadaver blood. It must be drawn within six hours after death from a subject with no known infectious disease, and a complete autopsy must be done. When these conditions are met, say the Pontiac doctors in Clinical Pathology, "we know it can do no harm and that it offers tremendous potential good."

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