Blood Organization During the Spanish Civil War

The Spanish Civil War (1936–1939) was the bloodiest conflict after WWI. During the war, both the Republic and the Nationalists, who fought each other, had organized medical services. The Republic had better blood transfusion services, with several notable experts, such as the Spanish Dr. Frederic Durán-Jordà (1905–1957) and the Canadian thoracic surgeon Norman Bethune (1890–1939). Stored blood was first used in Spain to heal war victims who needed immediate care. From the very beginning of the war, the demand for enormous amounts of blood surged dramatically. The blood transfusion service by the Republican Army coordinated and ensured blood drives with enough blood donors and consequently enough stored blood that was tested and transported all over Spain for patients in need. Blood drives were organized, in which thousands of blood donors regularly donated their blood. The Barcelona blood transfusion service served as a model for similar systems in other parts of Spain. Stored blood was transported to the frontline several kilometers from the transfusion service facility with refrigerator-equipped vehicles. The anticoagulant was sodium citrate, which was mixed with the donated blood and kept in a flask. To this blood, sometimes glucose solutions were added. In this desperate war, the solidarity of humane blood donors helped save many endangered lives.