Partner Makes Perfect: The Pairs of Researchers Behind the Apheresis Machine
One, it’s been said, can be a lonely number. Whether or not that’s true is up for debate, but what has been proven time and time again is that pairs of people working together can reach great heights — accomplishing things together that neither one could do on his or her own. History is littered with examples from Ben and Jerry to Lewis and Clark and Simon and Garfunkel. The transfusion medicine field also is indebted to the collaboration of partners for devising a critical invention that changed the way we collect and process blood — the apheresis machine. Without the partnerships of Judson and Freireich and Latham and Cohn, the apheresis machine might not exist as it is today — a device that, by allowing individuals to donate only a portion of their blood and retain the rest, has saved thousands of lives.
Judson and Freireich
In 1962, on the day that the seed for the apheresis machine was planted, IBM engineer George Judson was facing every parent’s worst nightmare: His son had leukemia, and Judson was headed to the National Institutes of Health for help from his home in New York.
Back in the early 1960s, NIH offered some of the best treatments for leukemia, but the process was burdensome. One treatment involved removing excess leukocytes from the patient — a painfully slow and labor-intensive endeavor.
Judson thought that there might be a way to improve the system. Perhaps the process could be done continuously with blood being removed and returned to the patient at the same time, making it more efficient.
Judson discussed his ideas with Emil Freireich, MD, DSc, a hematologist and senior NIH investigator at that time. Freireich was intense about solving problems to better his patients’ lives. His lab was full of wrenches, plastic tubing and mechanical parts. Around the time he met Judson, he was working on a machine that could function as an artificial kidney. As Judson explained his desire to develop a new method to remove white cells, Freireich had some initial reserve. “At first I thought he was a bit of a loon, but then again I never turn down any opportunities,” said Freireich, 82, now director of the adult leukemia research program at University of Texas M.D. Anderson Cancer Center.
Freireich took out a pencil and began to draw. From a physician’s point of view, he laid out the major requirements for a machine that would be useful and practical for treating leukemia patients.
The operation, he said, should be “vein to vein”; conducted on a continuous flow basis; and should minimize the loss of platelets, red cells and plasma. It should be a completely “closed system” to avoid bacterial contamination or air injection and reasonably automated.
“Judson just looked at the drawing and said ‘OK’ and went back to New York,” Freireich said. “About six months later, he reappeared in my office carrying a bunch of heavy hardware made out of plastic, screws and bolts. I couldn’t believe it.”
Judson and Freireich tested the prototype at NIH with rejected blood. It didn’t work perfectly, but they kept trying. Judson went back and forth from New York to Maryland, collaborating with Freireich in developing and testing many prototypes.
After about a year of working together, they thought they had something worth showing. They still couldn’t test the machine on a patient, but they could run it using real blood. Freireich called in his boss and other stakeholders for a demonstration.
It was a disaster. The machine ran, but one of the seals leaked. The physicians’ white coats were streaked red, and everyone was splashed with blood.
To the surprise of both men, and after some cleaning, the participants seemed intrigued. “Oddly enough, they thought it was promising because the principle was sound,” Freireich said.
The NIH top administrators eventually gave the go-ahead, and a contract between IBM and NIH was formally negotiated and funded to develop the first working instrument. NIH provided an initial grant of $13,000, and IBM officially assigned Judson to the project.
Judson and Freireich continued refining the machine, replacing the deficient seals and going through various test runs. After a considerable number of tweaks, the IBM 2990 — the world’s first continuous flow apheresis machine — was born. Freireich and Judson published a paper in 1965 describing how the machine operated. A year later, the IBM 2990 was officially introduced by NIH.
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