Historical overview of transplantation

Abstract

Except for legends and claims of miracles, most histories of transplantation cover only the last 60 years because there were no earlier successes. However, the story of even this era has been documented in such rich detail that a full account would fill several volumes. Thus, this brief summary must be limited to highly selected "landmarks." Some landmarks had an immediate impact, but the importance of others went unrecognized for decades. Some findings that deserved landmark status were overlooked or forgotten, whereas others of no biological significance had major impact. Placing these events in perspective is challenging. Several of transplantation's pioneers are still alive, and most of the others are within living memory. Virtually all of them have produced their own accounts. For the most part, they agree on what the "landmarks" are, but their differences in emphasis and perspective make an interesting story.

Figure 1.

Alexis Carrel, whose pioneering work on blood vessel suturing and organ transplantation was recognized by the 1912 Nobel Prize. (Photograph ca. 1907 from the collection of the American Surgical Association.)

Figure 2.

Peter Medawar skin-grafting a cow. The unexpected acceptance of grafts exchanged between chimeric bovine fraternal twins was the key to understanding tolerance. (The photograph is a gift from the private collection of Rupert Billingham, who was the photographer.)

Figure 3.

Rupert Billingham and Leslie Brent in their laboratory, where they inoculated neonatal mice with spleen cells (upper insert). In adulthood, the mice accepted skin homografts from the donor strain (lower insert). (The photographs are a gift from Rupert Billingham’s private collection.)

Figure 4.

Joseph Murray and his team performing the first successful kidney transplant in 1954 using as a donor the recipient’s identical twin.

Figure 5.

Participants in the March 1999 meeting of the third Annual Longmire Surgical Society Scientific Day Symposium at UCLA: Milestones in Transplantation. This group arrived at a consensus on the Historical Landmarks in Clinical Transplantation. (Front row, left to right) Robert Good, Norman Shumway, E. Donnell Thomas, Joseph Murray, Jean Dausset, and Jon Van Rood. (Back row, left to right) Leslie Brent, Roy Calne, Paul Terasaki, Robert Schwartz, Carl Groth, and Thomas Starzl.