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Karl Landsteiner—Discoverer of the Major Human Blood Groups

      Karl Landsteiner first published his seminal discovery about blood types as a footnote in a paper on pathologic anatomy in which he described the agglutination that may occur when the blood of one person is brought into contact with that of another. Others had demonstrated differences among various animals, but in the paper with the famous footnote, Landsteiner noted physiologic differences among humans. The following year, he described 3 blood groups: A, B, and C (C was later designated as O). In 1908, Adriano Sturli, a student of Landsteiner, and Alfred von Decastelo described the fourth major blood group, AB. Apparently, Landsteiner did not recognize the potential importance of the blood groups when he wrote, “I hope this will be of some use to mankind.” The discovery of the major human blood groups and the introduction of citrate to prevent clotting (Richard Lewisohn, Luis Agote, and Albert Hustin) led to the acceptance and frequent use of transfusion.
      Landsteiner was born on June 14, 1868, in Baden bei Wien, a suburb of Vienna, Austria. He was an outstanding student and entered medical school at the University of Vienna in 1885. He received his MD degree 6 years later. He worked with Otto Kahler (1849–1893) at the Second Medical University Clinic in Vienna in 1891, then studied with Emil Fischer (1852–1919) in Würzburg, Germany, in 1892; Eugene Bamberger (1857–1932) in Munich, Germany, from 1892 to 1893; and Arthur Hantzsch (1857–1935) in Zurich, Switzerland, from 1893 to 1894. He worked with Eduard Albert (1841–1900) in the First Surgical University Clinic from 1894 to 1895, followed by a year as an assistant to Max von Gruber (1853–1927) in the Department of Hygiene at the University of Vienna. In 1897, Landsteiner became assistant to the director of the Pathological Anatomical Institute in Vienna. His major responsibility was to perform autopsies, and he performed 3639 of them during the next 10 years.
      In 1904, Landsteiner and Julius Donath (1870–1950) described a test for the diagnosis of paroxysmal cold hemo-globinuria. Paul Ehrlich (1854–1915) had attributed hemo-globinuria to changes in the endothelium of the blood vessels. Landsteiner, however, noted that an antibody became active when exposed to the cold, but under warm conditions, it produced hemolysis.
      In 1905, Landsteiner and Ernest Finger (1856–1939) studied monkeys infected with syphilis and demonstrated spirochetes with dark-field microscopy. Previously, spirochetes could be seen only in stained sections of tissue. Subsequently, Landsteiner demonstrated that the Wassermann test could be performed using bovine hearts rather than human tissue.
      After performing a postmortem examination of a child who had died of poliomyelitis in 1908, Landsteiner injected a homogenate of the child's brain and spinal cord into rhesus monkeys. Paralysis developed in the monkeys 6 days later, and the histological appearance of the central nervous system was similar to that of humans who had died of the disease. Landsteiner postulated that the disease was due to a virus. He and Romanian scientist Constantin Levaditi (1874–1953) developed a procedure for the diagnosis of poliomyelitis.
      Landsteiner was a dissector at the Royal-Imperial Wilhelminen Hospital in Vienna from 1908 to 1919. From 1919 to 1922, he was the chief dissector in a small hospital in The Hague, Netherlands. He was responsible for analyzing samples of urine and blood and performing Wassermann tests and autopsies. His laboratory was limited to 1 room that was also used by other physicians. In 1922, he accepted an invitation from Simon Flexner (1863–1946) to join the staff of the Rockefeller Institute for Medical Research in New York City, and for the first time, he had his own laboratory. He became an American citizen in 1929.
      During the 1920s, Landsteiner and Phillip Levine (1900-1987) discovered the blood factors MN and P. In 1940, Landsteiner, Levine, and Alexander Wiener (1907–1976) described the Rh (Rhesus) factor. Landsteiner's work culminated in the 1936 publication of a book in German, which was translated into English in 1947 (The Specificity of Serological Reaction). Although he received the Nobel Prize for physiology or medicine in 1930 for “recognition and discovery of the human blood groups,” Landsteiner believed that his contribution of the specificity of serologic reactions was more important than the award-winning work.
      Landsteiner died on June 26, 1943, at the age of 75 years. He was honored on a stamp issued by Austria in 1968.