User:Keilana/Transplantation

The history of organ transplantation ultimately stretches back to ancient times. Conceptual origin in ancient times, first attempts (experiments in ancient world, etc). First LRRTx on identical twins. Discovery of blood typing and HLA typing made it possible without identical twins - Christiaan Barnard gave it a go but cyclosporine & Norman Shumway made long-term transplantation success.

Prehistory and mythology

 * Bone grafts (orthotopic autografts) from trephination - Bronze Age surgeons would remove a disc of skull and replace it post-trephination
 * Christian saints swapping out legs
 * Teeth and skin?

India

 * Autografts of skin in plastic surgery (see: history of plastic surgery) for nose/chin reconstructions with free-flap technique

Other locations (teeth)

 * Europe - Job van Meeneren (sp?) xenograft of dog bone to repair a skull defect

Skin

 * Peter Medawar - experiments in full thickness vs split thickness skin grafts, discovery that twins did better (in cows) led to immunologic tolerance discovery and early immunomodulation with steroids (aka crushed rabbit adrenals)

Alexis Carrel

 * Dog experiments - neck kidneys, being a terrible eugenicist who also won a Nobel, probably find some art depicting his experiments
 * Discovery of rejection as a concept

Xenotransplantation

 * 1905-1909 rabbit/pig/monkey kidney attempts by M Princeteau and Mathieu Jaboulay (Fr), Ernst Unger (De)

Early attempts

 * 1936: Voronoy transplants a kidney 6 hours post cardiac death B+ -> O, remained anuric and recipient died within 2 days
 * 1945: Murray and Hume transplant a kidney with technical success (? - need verification)
 * 1952: French surgeons harvest kidneys from guillotined people and attempt transplant, recipients all die from rejection
 * First success (?) - LRRTx mother to son in France, extraperitoneal kidney, 3 weeks of function before rejection
 * 1951-1952 - technical refinement in the US (9 transplants at Brigham), cortisone used to prevent rejection without success

First successes

 * Based on Medawar's experiments with skin grafts, identical twins with one in renal failure on early HD (Kolff Brigham dialysis, see history of dialysis)


 * blood transfusion - discovery of blood typing etc
 * Barnaard/Shumway et al, cyclosporine, cross circulation/bypass
 * we also need history of cardiac surgery
 * kidneys/lungs/etc (history of dialysis also??)
 * livers and Starzl
 * UW, organ bouquets
 * Social implications of transplants especially 80s-90s
 * ECMO, LVADs, lung box, etc
 * Living liver & kidney transplants
 * DCD vs brain death (and possibly the history thereof)

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