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Technology transfer: the DeBakey roller pump

The DeBakey roller pump is the device that made possible the first successful open-heart surgery in 1953. Almost forgotten is that it was invented for use in direct donor-to-patient transfusion by Michael DeBakey as a medical student in the 1930s. Citrated stored blood became available soon thereafter and the roller pump became obsolete for transfusion. Motorized, it went on to drive heart-lung machines. 1 Even before the pump, DeBakey had reported on a simple syringe-valve transfusion apparatus. With the genius of those who produce the best and then go on to improve upon that, DeBakey introduced his continuous-flow transfusion pump in 1934 (see figures). Roller pumps had been used for transfusion since the 1870s but suffered from the problem of "creeping" of tubing along the roller circuit. DeBakey attached a flat flange to a length of gum-rubber tubing and anchored it between the rollers. The tubing was then flushed with sterile liquid petrolatum and it could pass up to 1 L of blood from donor to recipient at one sitting. A ratchet prevented backflow and a counting device metered the amount delivered. DeBakey, along with pathologist Robert Kilduffe, published a book in 1942 with more than 2500 references and 200 line drawings and photographs. 2 It provides a record of world transfusion practice with animal blood and milk and then human plasma and blood by cannula, syringe, and pump. It provided the first major presentation of John Elliott's vacuum bottle for citrated blood that became standard in World War II. An issue stamped Med. Dept. U.S.A. was distributed by the Army and it is still invaluable in identification of the methods and tools that evolved into the transfusion practice of today. Like both book and bottle, DeBakey went to war. He returned for an eminent career in the cardiac surgery that depends on transfusion technology that he pioneered.