HISTORY OF ORGAN AND TISSUE TRANSPLANT


Organ transplants became possible because of the pioneering efforts of many.  The first clinically successful organ transplant occurred in 1954 between identical twins at the Peter Bent Brigham Hospital in Boston performed by Dr. Joseph E. Murray, who was later awarded the Nobel Prize for Medicine in 1990. However, few know that it was the successful transplantation of bone, skin and corneas that started between 1900 and 1920 that paved the way for further development of other tissues and organs to be transplanted successfully. The US Navy established the first bone and tissue storage facility in 1949.

The first successful recorded bone graft was in in 1668 when Job van Meeneren used bone from a dog’s skull to repair a defect in a human in the Netherlands.  Fresh skin autograft was demonstrated by Berger in 1822 and the first skin allograft was performed by Swiss surgeon Reverdin in 1868. The first successful corneal transplant was in 1906 by Edward Zirm followed by a cadaveric knee joint transplant by Eric Lexer in 1908.

Dr Thomas Starzl performed the first liver transplant at the University of Colorado in 1963, which was quickly followed by the first lung transplant by Dr James Hardy at the University of Mississippi in in 1964 and the first heart transplant by Dr Christiaan Barnard in 1967 at Groote Schuur Hospital in South Africa.

The Uniform Anatomical Gift Act was set up in 1968, drafted by the National Conference of Commissioners on Uniform State Laws (NCCUSL) with the intention of harmonizing state laws for the purposes of organ donation. The Harvard Criteria for the Determination of Brain Death was the first to define brain death based on neurologic criteria.

Dr Lillehei performed the first pancreas transplant at the University of Minnesota in 1969. Tissue transplantation was taken to greater heights in the 1970’s by the use of cryopreserved heart valves by O’Brien in Australia  and Angell in the US, use of cryopreserved skin allografts and the use of a cryopreserved venous allograft by Dent and Weber (1973).

Use of immunosuppressant medications was also introduced in 1978 (cyclosporin) which was developed in Cambridge by Dr Roy Calne and by Dr Starzl in Pittsburgh.

Dr Norman Shumway is credited for being the first to do a combined heart/lung transplant at Stanford in 1981. The National Transplant Act, which was set up in 1984, legislates federally funded centralized waiting list for organ recipients, outlaws buying and selling of human organs and mandates establishment of scientific registries to monitor transplant centers, Organ Procurement Organizations and hospitals.

By 1996, almost 500,000 tissue transplants were performed in the US.
The first partial face transplant was performed in France in 2005 followed by first successful near total face transplant  was performed at the Cleveland Clinic by Siemionow. Barret and colleagues in Barcelona performed the first full face transplant in 2010.

Extremity transplants started in Germany  with the first successful complete double arm transplant (2008) and the first double leg transplant in 2011 in Spain.