to cardiac arrest and sudden death. frequency of use globally around 85 million units of red blood cells are transfused in a given year. in the united states, blood transfusions were performed nearly 3 million times during hospitalizations in 2011, making it the most common procedure performed. the rate of hospitalizations with a blood transfusion nearly doubled from 1997, from a rate of 40 stays to 95 stays per 10,000 population. it was the most common procedure performed for patients 45 years of age and older in 2011, and among the top five most common for patients between the ages of 1 and 44 years. according to the new york times: "changes in medicine have eliminated the need for millions of blood transfusions, which is good news for patients getting procedures like coronary bypasses and other procedures that once required a lot of blood." and, "blood bank revenue is falling, and the decline may reach $1.5 billion a year this year from a high of $5 billion in 2008." job losses will reach as high as 12,000 within the next three to five years, roughly a quarter of the total in the industry, according to the red cross. history beginning with william harvey's experiments on the circulation of blood, recorded research into blood transfusion began in the 17th century, with successful experiments in transfusion between animals. however, successive attempts by physicians to transfuse animal blood into humans gave variable, often fatal, results. pope innocent viii is sometimes said to have been given "the world's first blood transfusion" by his physician giacomo di san genesio, who had him drink (by mouth) the blood of three 10-year-old boys. the boys subsequently died, as did the pope himself. the evidence for this story, however, is unreliable and considered a possible anti-jewish blood libel. the incas the first reported successful blood transfusions were performed by the incas as early as the 1500s. spanish conquistadors witnessed blood transfusions when they arrived in the sixteenth century. the prevalence of type o blood among indigenous people of the andean region meant such procedures would have held less risk than blood transfusion attempts among populations with incompatible blood types, which contributed to the failures of early attempts in europe. animal blood richard lower pioneered the first blood transfusion from animal to human in 1665 at the royal society. working at the royal society in the 1660s, the physician richard lower began examining the effects of changes in blood volume on circulatory function and developed methods for cross-circulatory study in animals, obviating clotting by closed arteriovenous connections. the new instruments he was able to devise enabled him to perform the first reliably documented successful transfusion of blood in front of his distinguished colleagues from the royal society. according to lower's account, "...towards the end of february 1665 selected one dog of medium size, opened its jugular vein, and drew off blood, until its strength was nearly gone. then, to make up for the great loss of this dog by the blood of a second, i introduced blood from the cervical artery of a fairly large mastiff, which had been fastened alongside the first, until this latter animal showed ... it was overfilled ... by the inflowing blood." after he "sewed up the jugular veins", the animal recovered "with no sign of discomfort or of displeasure". lower had performed the first blood transfusion between animals. he was then "requested by the honorable boyle ... to acquaint the royal society with the procedure for the whole experiment", which he did in december 1665 in the society's philosophical transactions. the first blood transfusion from animal to human was administered by dr. jean-baptiste denys, eminent physician to king louis xiv of france, on june 15, 1667. he transfused the blood of a sheep into a 15-year-old boy, who survived the transfusion. denys performed another transfusion into a labourer, who also survived. both instances were likely due to the small amount of blood that was actually transfused into these people. this allowed them to withstand the allergic reaction. denys's third patient to undergo a blood transfusion was swedish baron gustaf bonde. he received two transfusions. after the second transfusion bonde died. in the winter of 1667, denys performed several transfusions on antoine mauroy with calf's blood. on the third account mauroy died. six months later in london, lower performed the first human transfusion of animal blood in britain, where he "superintended the introduction in arm at various times of some ounces of sheep's blood at a meeting of the royal society, and without any inconvenience to him." the recipient was arthur coga, "the subject of a harmless form of insanity." sheep's blood was used because of speculation about the value of blood exchange between species; it had been suggested that blood from a gentle lamb might quiet the tempestuous spirit of an agitated person and that the shy might be made outgoing by blood from more sociable creatures. coga received 20 shillings (equivalent to £183 in 2021) to participate in the experiment. lower went on to pioneer new devices for the precise control of blood flow and the transfusion of blood; his designs were substantially the same as modern syringes and catheters. shortly after, lower moved to london, where his growing practice soon led him to abandon research. these early experiments with animal blood provoked a heated controversy in britain and france. finally, in 1668, the royal society and the french government both banned the procedure. the vatican condemned these experiments in 1670. blood transfusions fell into obscurity for the next 150 years. human blood james blundell successfully transfused human blood in 1818. the science of blood transfusion dates to the first decade of the 20th century, with the discovery of distinct blood types leading to the practice of mixing some blood from the donor and the receiver before the transfusion (an early form of cross-matching). in the early 19th century, british obstetrician dr. james blundell made efforts to treat hemorrhage by transfusion of human blood using a syringe. in 1818 following experiments with animals, he performed the first successful transfusion of human blood to treat postpartum hemorrhage. blundell used the patient's husband as a donor, and extracted four ounces of blood from his arm to transfuse into his wife. during the years 1825 and 1830, blundell performed 10 transfusions, five of which were beneficial, and published his results. he also invented a number of instruments for the transfusion of blood. he made a substantial amount of money from this endeavour, roughly $2 million ($50 million real dollars). in 1840, at st george's hospital medical school in london, samuel armstrong lane, aided by blundell, performed the first successful whole blood transfusion to treat haemophilia. however, early transfusions were risky and many resulted in the death of the patient. by the late 19th century, blood transfusion was regarded as a risky and dubious procedure, and was largely shunned by the medical establishment. work to emulate james blundell continued in edinburgh. in 1845 the edinburgh journal described the successful transfusion of blood to a woman with severe uterine bleeding. subsequent transfusions were successful with patients of professor james young simpson after whom the simpson memorial maternity pavilion in edinburgh was named. various isolated reports of successful transfusions emerged towards the end of the 19th century. the largest series of early successful transfusions took place at the edinburgh royal infirmary between 1885 and 1892. edinburgh later became the home of the first blood donation and blood transfusion services. 20th century william stewart halsted, m.d. (1852–1922) performed one of the first blood transfusions in the united states. only in 1901, when the austrian karl landsteiner discovered three human blood groups (o, a, and b), did blood transfusion achieve a scientific basis and become safer. landsteiner discovered that adverse effects arise from mixing blood from two incompatible individuals. he found that mixing incompatible types triggers an immune response and the red blood-cells clump. the immunological reaction occurs when the receiver of a blood transfusion has antibodies against the donor blood-cells. the destruction of red blood cells releases free hemoglobin into the bloodstream, which can have fatal consequences. landsteiner's work made it possible to determine blood group and allowed blood transfusions to take place much more safely. for his discovery he won the nobel prize in physiology and medicine in 1930; many other blood groups have been discovered since. george washington crile is credited with performing the first surgery using a direct blood transfusion in 1906 at st. alexis hospital in cleveland while a professor of surgery at case western reserve university. jan janský also discovered the human blood groups; in 1907 he classified blood into four groups: i, ii, iii, iv. his nomenclature is still used in russia and in states of the former ussr, in which blood types o, a, b, and ab are respectively designated i, ii, iii, and iv. dr. william lorenzo moss's (1876–1957) moss-blood typing technique of 1910 was widely used until world war ii. william stewart halsted, m.d. (1852–1922), an american surgeon, performed one of the first blood transfusions in the united states. he had been called to see his sister after she had given birth. he found her moribund from blood loss, and in a bold move withdrew his own blood, transfused his blood into his sister, and then operated on her to save her life. blood banks in wwi main article: blood bank dr. luis agote (2nd from right) overseeing one of the first safe and effective blood transfusions in 1914 while the first transfusions had to be made directly from donor to receiver before coagulation, it was discovered that by adding anticoagulant and refrigerating the blood it was possible to store it for some days, thus opening the way for the development of blood banks. john braxton hicks was the first to experiment with chemical methods to prevent the coagulation of blood at st mary's hospital, london in the late-19th century. his attempts, using phosphate of soda, however, proved unsuccessful. the belgian doctor albert hustin performed the first non-direct transfusion on march 27, 1914, though this involved a diluted solution of blood. the argentine doctor luis agote used a much less diluted solution in november of the same year. both used sodium citrate as an anticoagulant. the first world war (1914-1918) acted as a catalyst for the rapid development of blood banks and transfusion techniques. canadian doctor and lieutenant lawrence bruce robertson became instrumental in persuading the royal army medical corps to adopt the use of blood transfusion at the casualty clearing stations for the wounded. in october 1915, robertson performed his first wartime transfusion with a syringe to a patient who had multiple shrapnel wounds. he followed this up with four subsequent transfusions in the following months, and his success was reported to sir walter morley fletcher, director of the medical research committee. world war ii russian syringe for direct inter-human blood transfusion robertson published his findings in the british medical journal in 1916 and, with the help of a few like-minded individuals (including the eminent physician edward william archibald (1872–1945), who introduced the citrate anticoagulant method), was able to persuade the british authorities of the merits of blood transfusion. robertson went on to establish the first blood-transfusion apparatus at a casualty clearing station on the western front in the spring of 1917. oswald hope robertson, a medical researcher and u.s. army officer, was attached to the ramc in 1917, where he became instrumental in establishing the first blood banks in preparation for the anticipated third battle of ypres. he used sodium citrate as the anticoagulant; blood was extracted from punctures in the vein and was stored in bottles at british and american casualty clearing stations along the front. robertson also experimented with preserving separated red blood cells in iced bottles. geoffrey keynes, a british surgeon, developed a portable machine that could store blood to enable transfusions to be carried out more easily. expansion alexander bogdanov established a scientific institute to research the effects of blood transfusion in moscow, 1925. the secretary of the british red cross, percy oliver, established the world's first blood-donor service in 1921. in that year, oliver was contacted by king's college hospital, where they were in urgent need of a blood donor. after