Transplantation Firsts, Part 1 – First Kidney Transplants
There have been many stops and starts with regard to transplants, in general. Kidney transplants were among the first to be attempted in modern times. Transplants of that organ were begun between animals in the early 1900s, followed by unsuccessful attempts to transplant animal kidneys into humans. It was not until the mid-20th century that the first successful human to human kidney transplantation was performed, which, in turn, set the standard for more advanced successful kidney transplants in the future.
The first successful kidney transplant of any kind was performed in Austria in 1902, when a dog’s kidney was transplanted into another dog’s neck. The kidney lasted for five days. The second attempt at a kidney transplant, albeit unsuccessful, was conducted in the same year, with the exchange of organs between a goat and a dog (http://www.renalmed.co.uk/history-of/renal-transplant). France was the location in 1909 for several animal to human kidney transplants attempts involving monkeys, dogs, goats, and lambs, but none achieved the desired results. The first human to human kidney transplant occurred in 1936 by Ukrainian doctor Yu Yu Voronoy, but that patient died 48 hours later without making urine, a milestone which would have indicated some success with the procedure (www.ncbi.nlm.nih.gov/pmc/articles/PMC2975407).
In the first half of the 20th century, kidney transplants were intended to be temporary, and only meant to last until the original kidney recovered. Science had not yet advanced to the point where methods for the body to permanently accept the organ had been discovered.
However, in 1954, the first successful living human to human kidney transplant took place between identical twins in Boston, with that kidney functioning for eight years. The fact that the individuals were twins was the key to allowing this procedure to be successful, as the body of the twin who received the organ did not view the donated liver as being foreign. As a result, the body’s immune system did not cause a reaction and a subsequent rejection of the transplanted organ.
Four years later, in 1958, the first kidney transplantation using immunosuppressants, also referred to as anti-rejection drugs, was performed. Without these drugs, the body sees the new organ as foreign, and either damages or destroys it. True to its name, the immunosuppressants resist the body’s immune system’s ability to reject the organ. These anti-rejection drugs served to overcome the biggest obstacle to transplants at that time, and opened the door for further transplantation milestones.
In 1959, using sublethal total body irradiation to suppress the patient’s immune system successfully for the first time, the first kidney transplant took place between non-identical (fraternal) twin siblings (http://www.renalmed.co.uk/history-of/renal-transplant). In the following year, the first successful non-twin sibling kidney transplant was undertaken, while in 1961, the first kidney transplant between non-siblings was recorded.
To round this off, a different barrier was breached in 1962 when the first successful kidney transplantation from a deceased donor occurred. Another milestone was reached with this procedure, as the immunosuppressive drug Azathioprine, now sold under the brand name Imuran, was first utilized.
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Topic for Saturday, January 27th posting – Transplantation Firsts, Part 2 – First Liver Transplants
Check out the YouTube video of this posting at https://youtu.be/9Ln31wKcla8