AABB History: Major Strides Made in First Decade

March 17, 2022

*Note: This article originally appeared in AABB News.

The accomplishments of AABB founders are truly remarkable, especially given the fact that they built an entire sector of health care from nothing. Much of what we take for granted today did not exist in the late 1940s and 1950s. We owe early AABB members gratitude for their vision and wisdom, mixed with a humble hope that their work will continue through continued efforts of today’s professionals.

As the Curtain Opens….     

Many AABB members might recall the 1950s from childhood. Others may have a general idea from movies or TV shows depicting the era. Cold War conflicts captured the headlines, and national defense was a major theme. It was a time of economic expansion, especially in the manufacturing and housing sectors of the economy. Political and social conservatism were the norm and conformity was “king” (apologies to Chuck and Elvis).

In medicine, too, horizons expanded. The decade saw the creation of polio vaccines, routine use of pacemakers and open-heart surgery, discovery of the link between tobacco use and cancer, and the development of many life-saving pharmaceuticals. Progress was not universal, however. A cure for cancer remained elusive, mental illness was largely ignored and the cost of health care was already spiraling upward. Millions of people had no health care and the idea that the federal government should take over the provision of medical care gained some momentum.

Impressive Beginnings

AABB’s first decade was impressive by any measure. Energized by the Blood Bank Institute meeting at which the association was established, AABB founders wasted no time in beginning their awesome task. An AABB constitution was quickly followed by a set of bylaws, governance structure and determination of membership categories and dues. By March of 1948, a multi-talented member, Julius Davenport, MD, created the AABB emblem.

Concurrently with creating a framework for an association, the founders launched a membership campaign. Executive Secretary Marjorie Saunders, LLB, mailed copies of the AABB constitution with a letter to county medical societies across the nation asking for contact details for blood banks in their areas that might wish to become members. She also sent the AABB constitution with a letter to other health-related organizations asking for their endorsement of AABB’s efforts.

The papers presented at the Blood Bank Institute meeting had demonstrated the wide variety of policies, processes and procedures in use by fledgling blood banks trying to meet local blood needs. Thus, those early months focused on standardizing techniques at the highest level of quality possible. Standardization in education and certification formed another critical interest, and AABB partnered with the American Society for Clinical Pathologists to make progress on honing and recognizing professional skills.

The meetings, phone calls and mailings needed to build an association from scratch all came at a cost —one that the young AABB treasury found challenging to pay. AABB needed more members. So the founders established a network of members to be state representatives and provided them with information packets to distribute to civic and fraternal organizations, medical societies, radio and television stations and other entities within their states. Staying connected at the grass roots, the representatives had four responsibilities, as follows:

  • Inform the public and stakeholders of AABB’s principles and purpose.
  • Encourage membership.
  • Submit reports of activities and successes to be shared with other members.
  • Accept donations on behalf of the association.

With no paid staff and an Executive Committee (6 or 7 people) instead of a Board of Directors, the AABB managed to publish a monthly newsletter and a member directory, plan and execute annual meetings, start major programs such as the AABB Clearinghouse (now National Blood Exchange), build the membership and treasury, produce both a Technical Manual and an Administrative Manual and pursue timely initiatives in response to the changing landscape of governmental and societal issues.

Then and Now

Fundamentally, much about the AABB of today is the same as it was in the 1950s — standard-setting is still a core activity, education and certification are a major focus and maintaining a cohesive, connected community is as important as ever. AABB still embraces a diverse membership and seeks productive partnerships with other organizations. Its members continue to care deeply about patients, donors and the nation’s blood supply.

The differences we notice today are perhaps in how AABB achieves its goals or in how the details have changed in the intervening years. For instance, AABB has always been active in response to national emergencies. In its first decade, the worry was a nuclear attack by another country. Then, AABB strongly encouraged inclusion of its members in government contracts to treat military troops as well as civilian casualties of such an attack. Today, however, disaster response addresses a wider variety of disaster types, notably those launched by individuals or caused by natural catastrophes. Systems of response are mature and well-defined.

Another example would be the over- and underuse of transfusion as a medical treatment. Even in the 1950s, AABB presentations, meeting minutes and monthly communications noted a need to deliver the right blood to the right patient at the right time — an adage still in use. Yet, in those early days, blood groups, anticoagulated storage capability and therapeutic value of transfusion were all relatively new areas of medical practice. The emphasis was on giving the right blood, true enough. However, not many practitioners were emphasizing ways to help the patient without administering blood.

In AABB’s early years, most of the transfusion-transmitted diseases commonly discussed today were unknown and other negative consequences (such as transfusion-related immunomodulation and bacterial contamination) were not well understood. Pharmaceutical and adjunct therapies were not common practice. Advances in technology such as pathogen inactivation were not  possible.

In Summary

Today’s AABB members can look back to the early days and say, “They did the best they could, given the circumstances.” It would also be correct to say, “They did the best, period.” Launching an association is not a small endeavor. The AABB founders made impressive progress within weeks and short months of being established. The impressive list of “firsts” continued for years to come. What a great legacy the founders gave us all!

Factoids from the 1950s

 It was a different time and yet… in some ways it wasn’t. Readers can decide for themselves what still resonates today.

  • 1947: One of the first committees formed was the Standards Committee, by AABB presidential appointment immediately following the close of the Blood Bank Institute.
  • 1947: The first official AABB resolution was to invite the national American Red Cross to membership. The next four were to offer AABB services to the military and government agencies in times of national emergency.
  • 1948: The first meeting of the Executive Committee was a marathon — 9:00 a.m. to 12:01 the next morning. Within 6 months they determined that a full Board of Directors was needed and they divided the country into eight regions, one director per region.
  • 1948: Marjorie Saunders reported that the most frequently asked questions in correspondence to the association were: “How do you establish a blood bank?” and “How do you recruit enough donors?”
  • 1949: The AABB bank balance in January was 44 cents. By November it had increased to $1,423.14. AABB was kept afloat financially by occasional donations of $50-$100 from staunch supporters.
  • 1949: Charles Drew, MD, presented an update on Washington, DC activities as part of the state representatives’ report in March.
  • 1949: Also in the state representatives’ report was an update from Florida discussing the use of low-titer group O whole blood.
  • 1949: The American Medical Association endorsed AABB.
  • 1953: The first edition of Technical Methods and Procedures of the American Association of Blood Banks (Technical Manual) was published. The price was $2.00/copy. Requests were received immediately for Japanese, French and German translations.
  • 1953: The membership directory included a physician from Japan.
    1953: The annual meeting was attended by individuals from Canada, Switzerland, Colombia and Japan.
  • 1954: The first exam was held for BB certification; 110 people took the exam, all but 13 passed.
  • 1954: The Organization and Administration of Blood Banks (Administrative Manual) was released. The price was $4.00/copy.
  • 1955: A reminder from President Merlin Trumbull, MD, to members advised that the use of “AAOBB” by many members should be discontinued and “AABB” used instead.
  • 1955: The monthly News Bulletin contained a Q&A about any special glue for making sure labels did not fall off the bottles in the refrigerator.
  • 1955: The first Karl Landsteiner Award was presented to Richard Lewisohn, MD, for his early use of sodium citrate as an anticoagulant. He knew Landsteiner personally and had been on the ship to Stockholm with Landsteiner for the Nobel Prize ceremonies.
  • 1956: Ads in the newsletter for disposable lancets included instructions on how to open the envelope and grip the lancet.
  • 1957: An AABB Code of Ethics was approved.
  • 1957: AABB Bulletin (now a revised and expanded monthly publication) reprinted four papers from California on the main problems facing blood banks at that time: inventory control, what is happening to donors, disaster planning and fear of change.
  • 1957: AABB introduced new formats for education including AABB regional workshops with demonstrations by local professionals and “sessions” at an annual meeting (lectures, panel discussion by speakers, Q&A with audience members) instead of the reading of papers.
  • 1958: Shirley Busch, MPH, was the first U.S. technologist to be certified as SBB.
  • 1958: The first 12 facilities were named as immunohematology reference laboratories.
  • 1958: The first 50 blood banks were accredited by AABB based on compliance with the Standards for a Transfusion Service.
  • 1958: President E. E. Muirhead, MD, noted, “We can consider the main formative years as over, and major productive years ahead.”
  • 1958: The first central office opened with staff in Chicago.
  • 1959: A significant growth in membership resulted in totals of 2,000 individuals and 500 institutions at the start of the year.