Landsteiner and Wiener discovered the Rh blood factor

Person: Karl Landsteiner
Lived: 1868–1943
Field: Pathology
From: Austrian-American

The story

Even after Karl Landsteiner discovered the ABO blood groups, some transfusions between apparently compatible people still caused dangerous reactions, and some newborn babies suffered from a mysterious and often fatal blood disorder. Something else in the blood was involved.

At the Rockefeller Institute for Medical Research in New York, Landsteiner worked with Alexander Wiener, a Brooklyn-born physician who had begun collaborating with him at about 23 and who also ran the blood transfusion service at the Jewish Hospital of Brooklyn. The Nobel Foundation notes that their studies of bleeding in newborns led to the discovery. They immunised rabbits with red blood cells from rhesus monkeys and found that the resulting serum also reacted with the red cells of most humans. Landsteiner's biography dates the identification of the factor to 1937, and the pair reported it in a short paper in 1940. They named it Rh, after the rhesus monkey.

People either have this factor on their red blood cells, and are Rh-positive, or lack it, and are Rh-negative. Its importance became clear when it was linked with a case described by Philip Levine and Rufus Stetson in 1939, in which a mother's serum reacted against blood that was matched for ABO. Matching donors and recipients for Rh as well as ABO groups made transfusions far safer.

The discovery also explained haemolytic disease of the newborn, which occurs when an Rh-negative mother's antibodies cross the placenta and attack the blood of her Rh-positive baby. Wiener went on to develop exchange transfusion methods that saved the lives of affected infants, and in 1946 Landsteiner, Wiener and Levine shared a Lasker Award for the work.

Later research turned the knowledge into prevention. Since Rh immune globulin was introduced in 1968, Rh-negative mothers can be given injections that stop them from producing harmful antibodies. With proper use, the risk of sensitisation falls from roughly 17 percent to well under one percent, and Rh disease has become largely preventable in modern antenatal care.

Why it matters

Rh testing protects transfusion patients, and the prevention it made possible spares pregnant women and their babies from a once-common, often fatal disease.