The Institute

Our vision

IHBT is an evolving centre of first-class medicine and cutting-edge research, as well as a friendly and safe organisation for patients and staff.

The Institute of Hematology is the largest hematology center in the Czech Republic and has been there for more than 70 years for all those who need truly specialized treatment. It is made up not only of top doctors, but also a team of eighty scientists who are searching for why hematopoietic disorders arise in the body and how to correct them as effectively as possible. Their results are among the best in the field.

This also makes the Institute of Hematology and Blood Transfusion more than just a hospital, both for patients with cancer such as leukaemia or myelodysplastic syndrome and for those with truly rare bleeding and platelet disorders.

IHBT in numbers

The outpatient clinic performs more than 21,000 treatments a year
More than 500 patients per year are admitted to our 40 beds
We perform over 6,000 procedures a year in the day hospital
Annual turnover is more than CZK 1.2 billion

History

Why was the IHBT founded in 1952 and what was its first task at that time?

The Institute of Hematology and Blood Transfusion in Prague (IHBT) was founded on 1 January 1952 together with a number of other departmental research institutes of the Ministry of Health. In the sixty years of its existence, it has become a prestigious workplace combining specialised medical care and diagnostics with intensive research activities in the field of hematology and blood transfusion.

The beginnings of the Institute - enthusiasm and enormous 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 - transfusiological 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 being prepared.

The managers and the majority of the staff were mostly fresh graduates of universities and secondary schools, their education often delayed by the closure of universities during the Second World War. The lack of experience in research work and the limited opportunities to learn about work in foreign workplaces were compensated for by young, often talented, employees with enthusiasm, hard study and the desire to contribute their work to the solution of scientific problems. Contact with the world was ensured by 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 a refereed journal, Excerpta Hematologica. The journal, distributed to haematological departments and transfusion stations throughout Czechoslovakia, contributed to the expansion of professional knowledge and filled the gap of 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 outset, the aim of the IHBT was to establish and ensure the organisation of the transfusion service and to participate in the supply of transfusion products to hospitals. Thus, organisational 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 gammaglobulin was prepared and taken into production by the Institute of Serums and Vaccines as a 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 in the clinical department. The research work involved the study of antibodies to tissue antigens.

Research on 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, 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 preparations 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 of its own, the production of antisera and the teaching of medical students in animal surgical techniques.

The biochemical departments were initially mainly concerned with the chemical, biophysical and binding properties of proteins and introduced new methods for their characterisation. A significant development of the subject 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, haemoglobin was studied in order to produce a haemoglobin infusion solution, differences between normal and pathological haemoglobin were sought and abnormal haemoglobins 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.

At the end of the 1950s, the department of tissue culture and isotopes was established, which captured new possibilities for the study of blood cells, their growth, metabolism and changes after the action of cytostatics and other drugs. Over the years, great experience has been gained in the cultivation of haemopoietic 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 important phase of the development of the Institute of Human Cancer Research 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 diagnostics 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 of the doctors, in addition to working at the bedsides of patients, were involved in programmes 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 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 haemophilia were addressed. Haemolytic 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 leukaemia were also addressed, monoclonal antibodies were studied and constructed to improve the quality of diagnostics.

Efforts to improve the environment and care of patients led to the construction of an intensive care unit (ICU) in 1976. Patients with acute leukaemia were first 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 transplantation unit. In addition, the clinical department served as a training facility for haematologists from all over the country and the doctors participated in teaching at the Institute for the Education of Physicians and Pharmacists.

Over the years, the problems solved and the methodologies used at the Institute of Hematology and Clinical Therapeutics have changed in relation to the level of knowledge and in accordance with world trends, and individual departments have been merged, divided, disappeared and new ones have been created. Throughout the entire existence of the Institute, its staff has been striving for the rapid introduction of modern clinical, diagnostic and experimental procedures, for the understanding of the processes leading to the development of haematological diseases and for the best ways of their treatment. Often, the experts at the 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.

The headquarters of the Institute of Blood and Genetics: formerly a monastery, now a hospital

Since its foundation, the main part of the Institute's buildings has been located in the historical part of Prague's New Town, founded as early as 1348 by Charles IV. In a place where religious buildings have been built and demolished over the centuries, where trade flourished, schools were founded, and artists lived and worked, medical facilities have a tradition of more than two centuries.

The 1902 building (Building A), which was part of the divisional hospital, was given to the Institute of Health Care 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 a single-storey old 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 documentation and some laboratories. The first floor was being modified to accommodate a clinical inpatient ward with the most necessary hematology laboratories. Small buildings near the main buildings were used for the necessary technical equipment.

Since its foundation, the Institute has had detached departments. The anti-shock solution research department with an analytical and physicochemical laboratory worked in Roztoky near Prague, in a factory for the production of antibiotics. There was also a plant for drying blood plasma. In 1957, this department was moved to the buildings of the Institute of Serums and Vaccines in Orionka na Vinohrady. In 1953, a workplace for work with experimental animals was established in Studničkova Street. The same purpose was served by the most distant workplace in Jilemnice in the Krkonoše Mountains, 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.

As the number of issues dealt with at the IHBT increased, so did the number of staff, and the fragmentation of departments made work more difficult. After complex negotiations with the conservationists, a two-storey extension was built on Building B (completed in 1976). This made it possible to relocate the department from Orion and to house the documentation, lecture room and medical rooms in the extension. In 1978, another building in the garden (Building C) was completed to house the farm administration, menagerie and new research laboratories. The departments were gradually relocated and the institute consolidated locally for more than ten years. Increasing demands on 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 Paediatric Oncology of the Motol University Hospital.

Since its foundation, the main part of the Institute's buildings has been located in the historical part of Prague's New Town, founded in 1348 by Charles IV. In a place where church buildings have been built and demolished over the centuries, where trade flourished, schools were founded, and artists lived and worked, medical facilities have a tradition of more than two centuries.

During Prof. Cetkovský's directorship, the campus has been developing and the concept of building use has been changing - with an emphasis on higher functionality and overall modernisation - with the focus always being on excellent care and the patient.