History of Clinical Solid Organ Transplantation

Karl Landsteiner classifies blood into three groups A, B and O. Group AB later added. This has been described as the beginning of modern Immunogenetics. Blood transfusion can legitimately be considered a type of transplantation

First Successful Cornea Transplant was performed by Austrian surgeon Dr. Eduard Zirm

French surgeon Dr. Alexis Carrel develops surgical techniques for sewing arteries and veins which are used in organ transplantation and other surgical procedures today

Little and Tyzzer in analysing tumour transplants between mice demonstrated that several dominant genes influenced the outcome of allogenic tumour grafts. They were able to show that tumours transplanted from one strain of mice to mice of the same strain were accepted, whereas, tumours transplanted to a different strain were rejected. This was the first in a series of experiments by several researchers over many years that lead to the discovery of the Major Histocompatibility Complex (MHC) and its role in transplantation. Little, C. C., Tyzzer, E.E. (1916). Further experimental studies on the inheritance of susceptibility to a transplantable tumour, carcinoma (JWA) of the Japanese waltzing mouse. J. Med. Res. 33, 393-453

Peter Gorer, working at the Jackson Laboratory discovered an antigen in mice which he named Antigen II. This was later discovered to be the same antigen that George Snell had named Fu and which he had demonstrated played a role in transplant rejection. In collaboration they discovered the genes encoding this antigen and named it H2 (H for histocompatibility and 2 for antigen II). This is the first early picture of what later came to be called the Major Histocompatibility Complex (MHC). The first published use of the term MHC was not until the 1970’s

British zoologist Peter Medawar used experimental skin transplants on animals to explain why burn victims from the bombing of civilians in England during World War II reject donated skin. This work enabled him to establish theories of transplantation immunity. Peter Medawar was awarded the Nobel Prize in Physiology or Medicine in 1960 for the ‘discovery of acquired immunological tolerance’

George Snell further characterised the MHC system. He carried out a series of mouse breeding experiments which showed that transplantability was determined by the presence of special antigens on the surface of the cell. He called these histocompatibility antigens. He also showed that these antigens were coded for by genes found within a limited area on chromosome 6. This area was called the major histocompatibility complex (MHC)

James Watson and Francis Crick, drawing on their own work as well as the unpublished work of others including Maurice Wilkins and Rosalind Franklin, publish ‘The Molecular structure of Nucleic Acids: A Structure for Deoxyribose Nucleic Acid’ in the scientific journal Nature. vol 171 pp 737-738. This was the first published article which described the double helix structure of DNA. Watson, Crick and Wilkins were awarded the Nobel Prize in Physiology or Medicine in 1962 ‘for their discoveries concerning the molecular structure of nucleic acids and its significance for information transfer in living material’

The first successful living-related donor kidney Transplant was performed. A kidney transplant between 23-year-old identical twins, one of who was dying from advanced glomerulonephritis was performed by Dr. Joseph Murray and Dr. David Hume, Brigham Hospital, Boston

Jean Dausset describes the first Human leukocyte antigen that he named MAC using leukoagglutination techniques he had earlier described in 1952. He went on to propose a complex system which he designated HU-1 but which was later renamed HLA for ‘Human Leukocyte Antigen’. Jean Dausset was awarded the Nobel Prize in Physiology or Medicine in 1980, together with George Snell and Baruj Benacerraf, for ‘their discoveries concerning genetically determined structures on the cell surface that regulate immunological reactions’

First successful deceased donor kidney transplant was performed by Dr. Joseph Murray and Dr. David Hume, Brigham Hospital, Boston. The patient received the new immunosuppressive drug azathioprine and lived for 21 months

First successful lung transplant was performed by Dr. James Hardy at the University of Mississippi Medical Centre. That same year Jon van Rood discovered the Bw4 and Bw6 series of HLA antigens

Julia and Walter Bodmer, with Rose Payne discovered the LA series of HLA antigens. The LA nomenclature was later to provide the last two letters of what became known as the HLA system. Bernard Amos organised the first International Histocompatibility Workshop

The first successful pancreas transplant from a deceased donor takes place. The recipient, who had uncontrolled diabetes and kidney failure, was a patient at the University of Minnesota Medical Centre

First successful liver transplant was performed by Dr. Thomas Starzl, University of Colorado, Denver, CO

First Successful Heart Transplant was performed by Dr. Christian Barnard, Groote Schuur Hospital, South Africa. The patient, 54-year old Louis Washkansky, received a heart from a 23-year-old woman who died in a car accident. The heart functioned until the patient died of pneumonia eighteen days later because of their suppressed immune system

The WHO nomenclature committee for factors of the HLA system is set up by Bernard Amos

Cyclosporin is isolated from the soil fungus Tolypocladium inflatum and its immunosuppressive capabilities discovered by scientists at Novartis

First Successful heart/lung Transplant was performed by Dr. Norman Shumway, Stanford University Medical Centre, Palo Alto, CA

1984 – 1987
Tacrolimus is discovered in a soil fungus by a Japanese team

Dr Joseph E. Murray (kidney transplant) and Dr E. Donnall Thomas (bone marrow transplantation) are jointly awarded the Nobel Prize in Physiology or Medicine 1990 ‘for their discoveries concerning organ and cell transplantation in the treatment of human disease’


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