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History of organ transplantation 

History of organ transplantation
Chapter:
History of organ transplantation
Author(s):

John R. Klinck

and Ernesto A. Pretto

DOI:
10.1093/med/9780199651429.003.0001
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date: 19 August 2019

Scientific and technical advances leading to successful organ transplantation began little more than a century ago and provide one of the most compelling narratives in the history of medicine. This complex multidisciplinary endeavour now saves the lives of tens of thousands of patients worldwide each year, offering them and countless others, otherwise dependent on dialysis, insulin, or parenteral nutrition, an excellent long-term quality of life. This success was built on the efforts of a small number of independent-minded clinicians and scientists, who worked tirelessly and with modest support to overcome what their peers regarded as insurmountable obstacles. Yet, especially between 1950 and 1980, they exploited every opportunity in a complex interplay of technical innovation, laboratory science, and empiric observation to bring their radical vision into the mainstream. This involved breakthroughs in several vital areas: techniques of vascular anastomosis, effective preservation of donated organs, laboratory and clinical evaluation of organ function, temporary maintenance of recipients with dialysis or cardiopulmonary bypass, and suppression of cellular immunity without overwhelming risk. Also critical were the advent of artificial ventilation, legal acceptance of the concept of brain death, and pivotal changes in social attitudes. By the early 1980s, despite many setbacks, all this had been achieved and clinical outcomes transformed. The hallmark of success was the establishment of regulatory organizations, ensuring the equitable distribution of organs, appropriate standards of care, and the monitoring and study of outcomes. An era of rapid expansion began, fostering refinement and further innovation that continue today.

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