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Luis Agote (September 22, 1868 – November 12, 1954) was an
Argentine Argentines, Argentinians or Argentineans are people from Argentina. This connection may be residential, legal, historical, or cultural. For most Argentines, several (or all) of these connections exist and are collectively the source of their ...
physician A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the Medical education, study, Med ...
and researcher. He was the first to perform a non-direct
blood transfusion Blood transfusion is the process of transferring blood products into a person's Circulatory system, circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used ...
using sodium citrate as an
anticoagulant An anticoagulant, commonly known as a blood thinner, is a chemical substance that prevents or reduces the coagulation of blood, prolonging the clotting time. Some occur naturally in blood-eating animals, such as leeches and mosquitoes, which ...
. The procedure took place in Rawson hospital in the city of
Buenos Aires Buenos Aires, controlled by the government of the Autonomous City of Buenos Aires, is the Capital city, capital and largest city of Argentina. It is located on the southwest of the Río de la Plata. Buenos Aires is classified as an Alpha− glob ...
on November 9, 1914. Agote was the first to perform this procedure in
the Americas The Americas, sometimes collectively called America, are a landmass comprising the totality of North America and South America.'' Webster's New World College Dictionary'', 2010 by Wiley Publishing, Inc., Cleveland, Ohio. When viewed as a sin ...
. Agote worked independently and separately from the Belgian surgeon Albert Hustin, who discovered that sodium citrate in tolerable quantities could anticoagulate blood for transfusion on March 27, 1914.


Biography

Agote was the son of a politician. He studied first in the Colegio Nacional de Buenos Aires, and then at the
University of Buenos Aires The University of Buenos Aires (, UBA) is a public university, public research university in Buenos Aires, Argentina. It is the second-oldest university in the country, and the largest university of the country by enrollment. Established in 1821 ...
Faculty of Medicine A medical school is a tertiary educational institution, professional school, or forms a part of such an institution, that teaches medicine, and awards a professional degree for physicians. Such medical degrees include the Bachelor of Medicine, ...
, where he was also a teacher. He graduated as a doctor in 1893 with a thesis about suppurative hepatitis. He became Secretary of the National Department of Hygiene in 1894 and became head of the leper hospital in 1895 on the island of Martin Garcia. He was elected Congressman in 1910 and Senator in 1916 of the legislature in Argentina.


First recorded transfusions

The first recorded blood transfusion was made between dogs by the English doctor Richard Lower around 1666. In 1667, French scientist Juan Bautista Denys transfused a human with animal blood. In 1900,
Karl Landsteiner Karl Landsteiner (; 14 June 1868 – 26 June 1943) was an Austrian-American biologist, physician, and immunologist. He emigrated with his family to New York in 1923 at the age of 55 for professional opportunities, working for the Rockefeller ...
identified some of the blood substances responsible for the agglutination of red blood cells, identifying blood groups for the first time and some of their incompatibilities. Direct transfusions were still not practiced at the beginning of the 20th century because it was impossible to keep unaltered blood outside the body for later use. After 6–12 minutes, coagulation begins manifested initially by a gradual increase of
viscosity Viscosity is a measure of a fluid's rate-dependent drag (physics), resistance to a change in shape or to movement of its neighboring portions relative to one another. For liquids, it corresponds to the informal concept of ''thickness''; for e ...
that terminates with almost complete solidification.
Coagulation Coagulation, also known as clotting, is the process by which blood changes from a liquid to a gel, forming a thrombus, blood clot. It results in hemostasis, the cessation of blood loss from a damaged vessel, followed by repair. The process of co ...
is the defense of an organism to staunch wounds and minimize hemorrhages. Now we know that clotting is almost totally formed by platelets fastened by a network of filaments of
fibrin Fibrin (also called Factor Ia) is a fibrous protein, fibrous, non-globular protein involved in the Coagulation, clotting of blood. It is formed by the action of the protease thrombin on fibrinogen, which causes it to polymerization, polymerize. ...
. Fibrin does not normally exist in blood and is created from protein plasma by the action of the
thrombin Prothrombin (coagulation factor II) is encoded in the human by the F2-gene. It is proteolytically cleaved during the clotting process by the prothrombinase enzyme complex to form thrombin. Thrombin (Factor IIa) (, fibrose, thrombase, throm ...
enzyme. Similarly, thrombin is not naturally present in blood and is created by the precursor substabrin, in a process that involves platelets, some exiting from calcium and substances produced by lesioned materials. Since clots are not created if there is a lack of some of these elements, the addition of sodium citrate (which eliminates calcium ions from blood) prevents its formation.


Agote's Investigation

Concerned about the issue of bleeding in hemophilic patients, he tackled the problem of long-term blood preservation with laboratory technician Lucio Imaz. His first attempts involving special containers and maintaining the blood work at a constant temperature were unsuccessful. He sought out for a substance that would aggregate the blood and avoid coagulation. After many in vitro laboratory tests and trials with animals, Agote, without the knowledge of its biochemical origin or biological behavior, found that sodium citrate prevented the formation of clots. This substance was tolerated and expelled from the organism without causing any major problems. The first human trials were performed on November 9, 1914, in a classroom at the Instituto Modelo de Clínica Médica (Argentina), having as witnesses the Rector of the
University of Buenos Aires The University of Buenos Aires (, UBA) is a public university, public research university in Buenos Aires, Argentina. It is the second-oldest university in the country, and the largest university of the country by enrollment. Established in 1821 ...
, Eufemio Uballes, the dean of the Faculty of Medicine, Luis Güemes, the General Director of Public Assistance, Baldomero Sommer, and the municipal mayor, Enrique Palacio, in addition to many other professors and doctors.


Acknowledgments

While living, the
University of Buenos Aires The University of Buenos Aires (, UBA) is a public university, public research university in Buenos Aires, Argentina. It is the second-oldest university in the country, and the largest university of the country by enrollment. Established in 1821 ...
recognized him as honorary professor and the National Academy of Medicine of Argentina named him as honorary member. Chile honored him in 1916 with the
Order of Merit (Chile) The Order of Merit () is a Chilean order of merit and was created in 1929. Succeeding the Medal of the Merit, which was created during the term of the President Germán Riesco through the Minister of War decree No. 1350 on 4 September 1906. This ...
.


References


External links


Agote's short biography
(Spanish)
Biography
(Spanish)
Genealogia Familiar
{{DEFAULTSORT:Agote, Luis 1868 births 1954 deaths Argentine inventors Health professionals from Buenos Aires University of Buenos Aires alumni Burials at La Recoleta Cemetery Leprologists 20th-century Argentine physicians