About Us
IHBT in numbers
- We carry out more than 21,000 treatments a year in our Outpatient Department
- We admit more than 500 patients a year on 40 beds
- We perform over 6,000 procedures a year in the Day Hospital
- IHBT has 467 staff members
- Our annual turnover is more than CZK 1.2 billion
History
Why was IHBT founded in 1952 and what was its first task at that time?
The Institute of Hematology and Blood Transfusion (IHBT) was founded in Prague on 1 January 1952 together with a number of other departmental research institutes of the Ministry of Health. Over the sixty years of its existence, it has become a prestigious institution combining specialized medical care and diagnostics with intensive research activities in the field of hematology and blood transfusion.
The beginnings of the Institute - enthusiasm and tremendous diligence
At the time of the Institute's establishment, research and other activities were mainly focused on projects whose results could be used to reduce the number of casualties in war conflicts – transfusiology issues, preparation of blood plasma substitutes and anti-shock solutions. This involved the introduction of biochemical, physicochemical and morphological methods of investigation, the study of plasma proteins and the beginnings of immunological studies. The conditions for opening a Clinical Department were still in preparation.
The managers and a large majority of staff members were mostly fresh graduates of universities and high schools, their education often delayed by the closure of universities during the Second World War. The lack of research experience and the limited opportunities to learn about work in foreign institutions were compensated for by young, often talented employees' enthusiasm, hard study and efforts to contribute to the solution of scientific problems. Contact with the world was ensured through the Institute's well-equipped library. In addition to the book collection, it provided a wide range of specialist periodicals and in 1954 it took the initiative to publish the refereed journal Excerpta Hematologica. The journal, distributed to hematological departments and transfusion stations throughout Czechoslovakia, contributed to the expansion of professional knowledge and filled the gap left by the difficult acquisition of foreign literature. A number of IHBT staff members prepared Excerpta, thus gaining an overview of world hematology, transfusiology and related fields as well as experience for writing their own publications.
Development of individual departments
From the very beginning, the aim of IHBT was to create and ensure the organization of the transfusion service and to participate in the supply of hospitals with transfusion products. Thus, organizational and methodological procedures for the whole country had to be developed, and the preservation of blood and blood elements was researched. Care was also taken to ensure and develop the safety of blood transfusion, taking into account the possibility of transmission of certain viral infections, especially hepatitis virus, later HIV and cytomegalovirus. Hyperimmune gamma globulin was prepared and taken into production by the Institute of Serums and Vaccines as HEPAGA preparation.
The Complementary Immunohematology Department determined blood groups and subgroups, created a bank of rare blood groups, studied leukocyte and platelet antigens and dealt with the determination of paternity. A Laboratory for HLA Antigen Typing was established and the topics dealt with in this department smoothly transitioned to the current search for suitable bone marrow donors. The Bacteriology Laboratory, in addition to checking the sterility of blood products and bacteriological control of rooms and equipment, also performed culture and antibiotic susceptibility testing for patients of the Clinical Department. Research activities included the study of antibodies to tissue antigens.
Research into anti-shock solutions and blood plasma substitutes was important in the early years. Protein solutions from animal plasma with suppressed antigenicity were developed, dextran production was introduced and successfully transferred to production process, and fractionation of blood plasma was carried out. The production of fibrin tubes and fibrin foam was a success. The Department of Experimental Physiology and Pharmacology tested transfusion products and preservative solutions for pyrogenicity, and monitored the efficacy of developed replacement solutions in the treatment of shock and immune response. This involved immunological research, the production of antisera and the training of medics in animal surgical techniques.
The biochemical departments were initially mainly concerned with chemical, biophysical and binding properties of proteins and introduced new methods for their characterization. A significant development of the field occurred after 1957 with the appointment of Professor Hořejší as Director of the Institute. Methods for fractionation of plasma proteins were developed, including original separations using Rivanol. In addition to plasma proteins, hemoglobin was studied in order to produce a hemoglobin infusion solution, differences between normal and pathological hemoglobin were sought and abnormal hemoglobins in patients were examined to clarify the diagnosis. Studies of cell membrane biochemistry, cytostatic effects of folic acid antagonists and fibrinogen polymerization were initiated. New analytical methods were introduced.
In the late 1950s, the Tissue Culture and Isotopes Department was established, which captured new opportunities to study blood cells, their growth, metabolism and changes after exposure to cytostatics and other drugs. Over the years, significant experience has been gained in the cultivation of hemopoietic cells and tumour cell lines, and work with isotopes has enabled the study of the survival of blood elements in circulation, lymphocyte stimulation and other diagnostic methods.
The next significant stage of the development of IHBT came in 1955 with the opening of the Clinical Department. The structure of the Institute and the main directions of research were adapted so as to aim at quality diagnosis and therapy of blood diseases. Professor Libánský, an experienced internist, became the first head of the Clinical Department. The department had 42 beds in six rooms and the necessary laboratory facilities. The X-ray Department fulfilled not only a diagnostic but also a therapeutic function. Most physicians, in addition to working at the patients’ bedsides, were involved in programs that from the beginning linked clinical and experimental issues. In the early years, laboratory methodologies were at the forefront, the therapeutic effects of the whole spectrum of cytostatics were monitored, immunological reactivity of patients was also monitored, and new cytomorphological methods, including electron microscopy, were introduced. Leucokinetics and thrombokinetics were monitored. Initial advances were made in the field of coagulation, and the diagnostic and therapeutic problems of hemophilia were addressed. Hemolytic conditions were studied from several points of view and new therapeutic procedures in the treatment of hematological malignancies were introduced in accordance with the findings of foreign centres. Tasks aimed at the study of experimental leukemia were also addressed; monoclonal antibodies were studied and constructed to improve the quality of diagnostics.
The effort to improve the environment and patient care led to the construction of an Intensive Care Unit (ICU) in 1976. At first, patients with acute leukemia were treated with modern procedures and the first allogeneic bone marrow transplantation was performed (1986). This was followed by the transfer of autologous cryopreserved bone marrow in 1990 and the first bone marrow transplantation from an unrelated donor in Czechoslovakia (1991), which was performed in the newly built Transplant Unit. In addition, the Clinical Department served as a training facility for hematologists from all over the country, and physicians took part in teaching at the Institute for the Education of Physicians and Pharmacists.
Over the years, the problems addressed and the methodologies used have changed at IHBT in relation to the level of knowledge and in accordance with world trends; individual departments have merged, split, disappeared and new ones have been created. Throughout the entire existence of the Institute, its staff members have been striving for a rapid introduction of modern clinical, diagnostic and experimental procedures, for the understanding of the processes leading to the development of hematological diseases and for the best ways of their treatment. Often, the experts at IHBT have been able to capture new directions in biochemistry, immunology, molecular biology and cytogenetics in time to expand quality diagnostics and therapy of blood diseases and basic research programs.
IHBT headquarters: A former monastery, now a hospital
Since its foundation, the bulk of the Institute's buildings was located in the historical part of Prague's New Town, founded in 1348 by Charles IV. In a place where church buildings were erected and demolished over the centuries, where trade flourished, schools were founded, artists lived and worked, medical facilities have a tradition of more than two centuries.
IHBT was granted the use of a building from 1902 (Building A), which was part of the divisional hospital and has a frontage on U Nemocnice Street. It still houses the Institute's Transfusion Station, immunohematology and some biochemical research laboratories. Another part of the Institute was originally an old single-storey monastery building (Building B), which served as a military hospital in the 18th century. In the early years of the Institute, the ground floor housed a library with a documentation centre and several laboratories. The first floor was adapted to accommodate a Clinical Inpatient Department with the most necessary hematology laboratories. Small buildings close to the main buildings were used for the necessary technical equipment.
Since its foundation, the Institute has had detached facilities. The Department of Research of Anti-Shock Solutions with the Analytical and the Physicochemical Laboratory worked at Roztoky near Prague, in a factory producing antibiotics. There was also a plant for drying blood plasma there. In 1957, this department was moved to the buildings of the Institute of Serums and Vaccines at Orionka in the Vinohrady quarter of Prague. In 1953, a facility for the work with experimental animals was established in Studničkova Street. The same purpose was served by the most distant facility at Jilemnice in the Giant Mountains (Krkonoše), which was closed down in the early 1990s. It was originally built as a replacement facility in case of war conflict and was to be equipped to allow the operation of the transfusion service and hematology laboratories.
The number of employees increased with the expansion of the issues dealt with at IHBT, and the fragmentation of the facilities made the work more difficult. After complex negotiations with preservationists, a two-storey extension was built on Building B (completed in 1976). This made it possible to relocate the department from Orionka and to house the documentation centre, lecture room and medical rooms in the extension. In 1978, another building in the garden (Building C) was completed to house the economic administration, an animal pen room and new research laboratories. The departments were gradually relocated and the Institute consolidated locally for more than ten years. Increasing demands concerning the quality of the facilities for working with products administered into the bloodstream of patients necessitated the relocation of the Bone Marrow Processing and Cryopreservation Department, together with the Cord Blood Bank, to the new building of the Department of Pediatric Oncology at the Motol University Hospital.