The first organs to be successfully transplanted were kidneys, in the early 1950s. Since then, doctors have learned to safely transplant hearts, lungs, and other organs, improving, extending, and saving countless lives.

Early efforts to transplant human organs ended in failure because the body rejected the new, transplanted tissue. Only when scientists realized that identical twins could receive transplants without risk of rejection was the first successful transplant performed. In 1954, the surgeon Joseph Murray (1919–) carried out the first successful kidney transplant on a pair of 23-year-old identical twins at Brigham and Women’s Hospital in Boston. Whether a transplant is likely to succeed depends on the similarity of donor and recipient, which is measurable by their sharing of immune markers called human leukocyte antigens (HLAs). A perfect match is six out of six of the major HLA markers, as are found in identical twins.

But few people have identical twins. After Murray proved the feasibility of transplants, scientists spent the next several decades searching for a way to make the surgery possible for nontwins—and even for people who weren’t related at all. To prevent the body from rejecting the new organ, researchers developed a powerful drug in the 1960s called cyclosporine, which suppressed the immune system. At first, immune-suppressing drugs were extremely dangerous, and many patients died shortly after surgery. By the 1980s, however, medications had improved and survival rates increased. Doctors have now successfully transplanted most body parts, including hands and, in 2005, a face for a French woman who had been mauled by dogs. Face transplants remain a controversial procedure because of the ethical and identity issues involved.

For conditions such as cirrhosis (a disease of the liver) and kidney failure, patients can receive organs from a living donor, often a friend or relative. Heart and lung transplants are usually considered only as last resorts and must come from recently deceased victims whose organs have been kept alive on artificial life support. (It is possible to transplant a lung from a living donor, but it’s very risky and very rare.) Today, the demand for organs has far surpassed the supply of donated organs available. In the United States, patients must go on a waiting list as part of the Organ Procurement and Transplantation Network, a division of the US Department of Health and Human Services.

ADDITIONAL FACTS

  1. Since 1982, more than 400,000 people in the United States have received new kidneys, hearts, livers, lungs, pancreases, or intestines.
  2. Doctors at Massachusetts General Hospital in Boston are currently studying ways to use pig organs for human transplants.
  3. A kidney transplant in 1950 allowed a woman to live for 5 more years, even though her body rejected the organ after only a few months. The 1954 operation is considered the first successful transplant, however, because that kidney functioned properly for at least a year.