Book details provocative, sometimes gruesome history of organ, blood donations

Today, a "blood drive" is a cheerful community event, featuring cookies and chats with the neighbors in the high school gym. But a century ago, the first successful blood donations occurred when two people were sewn together by their blood vessels as blood flowed from the donor to the recipient.

Susan Lederer, chairwoman of the department of medical history and bioethics at the University of Wisconsin School of Medicine and Public Health, has published a new book on the sometimes gruesome history of blood transfusion and organ transplantation. Her book, "Flesh and Blood: Organ Transplantation and Blood Transfusion in Twentieth-Century America," was published this spring by Oxford University Press.

Lederer says physicians turned to human donors, in part, because it was too difficult to manage the animals.

"It was hard to get an animal upstairs to a bedroom where a woman had just lost a lot of blood in childbirth,” she says. "Husbands were around, so they could be tapped as donors."

But solving the technical aspects of blood transfusions created other challenges. Blood transfusions also raised concerns about infection with dread diseases such as syphilis, of mixing blood between races, and of religious issues with groups such as Jehovah’s Witnesses.

Lederer also looks at the development of organ transplants in the 20th century. Early on, there was concern about trade in human organs. In a 1903 advertisement in the New York Times, a man offered $5,000 for a right ear, to replace one he lost in an accident. The operation was reported as a success. But by the 1920s, a fad for transplanting the testicles of young men to give renewed vigor to rich elderly recipients led one biologist to decry "the despicable traffic in organs."

Lederer’s book explores the history of selling blood, skin and body parts for profit. By the 1930s, there was a "blood sellers’ union" affiliated with the American Federation of Labor. Lederer argues that even today’s terms of "blood banks" and "organ banks" come from the confluence of ideas about the circulation of money and the circulatory system of the body.

It wasn’t until World War II, when donating blood was associated with patriotic duty, that altruistic blood donations became more common. Even as late as the 1970s, American-donated blood tended to come from prisoners and the destitute, Lederer says, causing the British to claim that "British blood was better because it was altruistically given." After a series on American "Blood that Kills" in England’s National Observer, President Richard Nixon established America’s first blood policy.

Lederer says that history shows that while many Americans profess "distaste for selling body parts,” there has long been a market for such products. And in the past few years, the perennial shortage of such donor organs as kidneys has encouraged new interest in establishing a legal market for organs and other financial incentives for donors and their families.

These and many other questions are raised by the provocative look at America’s first century of blood and organ donations.