Milestones in Organ Transplantation

1906 The first kidney transplantations are done without anti-rejection drugs. Kidneys from sheep, pigs, goats and primates are used.

1936 Dr. Voronoy, a Russian, reports the first human-to-human kidney transplant, when a kidney from a deceased donor is transplanted to a recipient with a different blood type.

1944 A British scientist, Sir Peter Medawar, reports that rejection of a transplant is based on immunologic factors. This discovery eventually transforms transplant surgery from a largely unsuccessful experiment to an accepted form of treatment.

1954 Surgeons Joseph E. Murray and John Hartwell Harrison, in collaboration with nephrologist John P. Merrill, perform the first successful kidney transplant -- between identical twins -- at the Peter Bent Brigham Hospital in Boston.

1963 Dr. Thomas E. Starzl performs the first human liver transplant at the University of Colorado Medical School; however, lack of effective immunosuppressives limits the success. Four years later, the availability of more effective immunosuppressives enables Dr. Starzl to perform the first successful liver transplant.

1963 Dr. James D. Hardy performs the first lung transplant at the University of Mississippi at Jackson; however, the patient survives only a few days because of the lack of effective immunosuppression drugs. Twenty years later, with improved immunosuppressives, Dr. Joel Cooper performs the first successful lung transplant at Toronto General Hospital.

1967 Dr. Christiaan Barnard performs the first heart transplant at Groote Shuur in Cape Town, South Africa.

1968 Dr. Norman Shumway performs the first U.S. heart transplant at Stanford University.

1968 Drs. Richard Lillehei and William Kelly perform the first pancreas transplant at the University of Minnesota Hospital.

1979 U.S. trials of Sandimmune in deceased donor kidney transplants begin at the Peter Bent Brigham Hospital in Boston and at the University of Colorado. The results show that Sandimmune (cyclosporine), combined with steroids, controls rejection better than any drug therapy in the past.

1983 The Federal Drug Administration releases Sandimmune (cyclosporine) for general use in the U.S., heralding a new era for kidney, liver and heart transplantation.

1986 Dr. A. Benedict Cosimi and his associates at Massachusetts General Hospital introduce monoclonal antibodies into clinical medicine in the form of OKT3 antibodies, which have a selective effect on the immune system and are intended primarily for reversing kidney transplant rejection.

1989 Clinical investigators begin using an experimental drug called FK 506 for kidney, liver, heart and lung recipients. Results suggest that this drug is effective, but clinical trials continue to assess its safety and efficacy.

1993 Continuing shortages in organ donation lead to renewed interest in transplanting organs from animals such as baboons (often referred to as xenografting). Baboon-to-human liver and heart transplants have been attempted, with limited success. A new research strategy involves developing a line of pigs with the appropriate human genes to help prevent rejection of organs such as hearts, livers and kidneys transplanted from these animals.

1994 The FDA approves a new medication for use in transplant recipients: Prograf (formerly known as FK506) marks a significant advance in the understanding and suppression of the human rejection response and in the lessening of unwanted side effects.

1995 A new study by Dr. Paul Terasaki and collegues at UCLA shows that spouses are an important source of living-donor kidney transplants. According to the Terasaki study, the 3-year graft survival rate for spouse-to-spouse transplants (85%) is comparable to that seen in parent-to-child transplants (82%) and better than that seen in transplants from deceased donors (70%). Living donation is becoming an increasingly important source of kidney and other transplants because of continuing shortages of deceased donors.

1995 Two more new medicines are approved by the FDA for use in transplant recipients. These are: CellCept (mycophenolate mofetil), and Neoral, a new formulation of cyclosporine. These drugs hold promise for providing even better control of rejection with fewer side effects.

1995 At Johns Hopkins Bayview Medical Center, Dr. Lloyd Ratner and Dr. Louis Kavoussi perform the world's first laparoscopic live-donor nephrectomy in which an individual's kidney is removed through a hole slightly larger than a silver dollar. Laparoscopic live-donor nephrectomies mean fewer post-op days in the hospital, speedier recovery, less scarring and decreased post-operative pain.

1996 The number of kidney transplants using living donors (both related and unrelated) continues to grow. A total of 11,099 kidney transplants are performed in 1996--3,389 of which involve kidneys recovered from living donors.

1997 The Department of the Navy Bureau of Medicine and Surgery announces a research breakthrough that raises new hope that acute transplant rejection may be prevented and reversed without the need for chronic immunosuppressant drugs. Navy researchers report that they are now able to prevent kidney transplant rejection in primates with different histocompatibility factors through the use of a combination of a specific fusion protein and a specific monoclonal antibody. Further trials are necessary to determine future applicability of the technique to humans.

1999 The Food and Drug Administration (FDA) approves Rapamune (sirolimus), a new immunosuppressant drug used to prevent organ rejection in patients receiving kidney transplants. This new drug is to be taken along with cyclosporine and corticosteroids.

2000 The United Network for Organ Sharing (UNOS) begins pilot testing two new programs aimed at increasing the availability of organs for transplantation. In "paired exchange," two incompatible living donor-recipient pairs may be able to swap donors so that each recipient can be transplanted. Another option is "list-paired exchange," in which a would-be donor who is mismatched with the intended recipient can still donate a kidney to the general pool. In return, the intended recipient advances on the waiting list for a non-living-donor kidney.

2000 Concern about the well-being of live organ donors leads the National Kidney Foundation and the American Societies of Transplantation, Transplant Surgeons and Nephrology to convene the Live Organ Donor Consensus Group. A set of recommended practice guidelines is developed by this group to assist transplant physicians, primary care providers and health care planners provide the best care for living donors and potential donors. The guidelines are published in the December 18, 2000 issue of the Journal of the American Medical Association.

2001

The number of living organ donors in the U.S. surpasses the number of deceased donors for the first time.



2001

New York becomes the sixth state to pass a law that grants paid leave for state employees who serve as living organ donors. These state laws serve to complement the Organ Donor Leave Act passed by the U.S. Congress in 1999. It is hoped that these laws will encourage private companies to make similar allowances for employees who wish to become living donors and, thus, help to increase the number of organs donated for transplantation.

2004

NKF helps pass the Organ Donation and Recovery Improvement Act, a federal fund to reimburse living donors for expenses incurred from organ donation.

2009

In response to the growing waiting list, NKF launches a set of groundbreaking collaborative initiatives to END THE WAIT! for a kidney transplant in the U.S. in 10 years.

Source: National Kidney Foundation, Inc.