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Organ Transplantation: A Historical Perspective

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Transplantation Surgery

Part of the book series: Springer Specialist Surgery Series ((SPECIALIST))

Abstract

Exciting the imaginations of doctors and patients for millennia, transplantation has struggled to overcome significant technical and biological barriers. Over the course of the last 150 years, physicians have worked in laboratories and operatories to find solutions to these problems. A generation of surgeons led by Alexis Carrel solved the technical problem of implanting organs, highlighting the potential of this therapy. Yet, these men consistently failed when exchanging organs between animals, rejected by hosts’ immune systems. After World War II, scientists like Peter Medawar uncovered some of the mysteries of rejection by elucidating the underlying immunology. Their discoveries focused attention on combatting this process, initially through agents like steroids and azathioprine, which allowed for limited success. It also opened searing questions over the definition of death. The introduction of calcineurin inhibitors transformed the field into a clinical reality and expanded the repertoire of possible organs to implant. It simultaneously created new problems of fairly distributing an extremely limited resource. Recent efforts have worked to solve both of these problems, with increased usage of biologics, organ perfusion systems, and ongoing experimentation into xenotransplantation. No straight line of progress, the field has swerved in as many incorrect directions as right ones, but through a combination of meticulous investigation and empirical forays, transplantation has transformed from a hope into a realistic cure for thousands of patients.

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Authors and Affiliations

  1. Duke University Department of Surgery, Durham, NC, USA

    Justin Barr

  2. Surgery and Head of the Department, University of Cambridge, Cambridge, UK

    J. Andrew Bradley

  3. Alexandria, MN, USA

    David Hamilton

  4. Fife, UK

    David Hamilton

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  1. Justin Barr
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  2. J. Andrew Bradley
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  3. David Hamilton
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Correspondence to Justin Barr .

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  1. Imperial College London, London, UK

    Nadey Hakim

  2. Başkent University, Ankara, Turkey

    Mehmet Haberal

  3. University of Virginia Medical Center, Charlottesville, VA, USA

    Daniel Maluf

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Barr, J., Bradley, J.A., Hamilton, D. (2021). Organ Transplantation: A Historical Perspective. In: Hakim, N., Haberal, M., Maluf, D. (eds) Transplantation Surgery. Springer Specialist Surgery Series. Springer, Cham. https://doi.org/10.1007/978-3-030-55244-2_1

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