Who Performed the First Kidney Transplant in the World?

On December 23, 1954 at Peter Bent Brigham hospital in Boston, Massachusetts the first successful kidney transplant in the world occurred and this was used to revolutionize the treatment of kidney failure.

This experiment, which was carried out by Dr. Joseph E. Murray and his colleagues on identical twins, proved that organ transplantation could be effective over a long period and not rejected immediately. The incident provided the groundwork of modern transplant medicine by saving millions of lives throughout the world.

When did Kidney Transplantation Start?

The attempts to perform the kidney transplantation go back decades, and the initial attempts have failed because the organism has rejected the foreign tissue. In 1933, Ukrainian surgeon Yuriy Vorony tried to perform a human kidney transplant on a dead donor, but the patient passed on soon. 

One remarkable experimental action of 1950, by Dr. Richard Lawler at the University of Chicago, was the implantation of a kidney of a deceased woman into the forearm of a man; it worked temporarily, but would be rejected without immunosuppressive medication.

It was essential to pioneer the work of the British immunologist Peter Medawar in the 1940s on the subject of tissue compatibility. His observations of skin grafts between identical twins (which were successful) gave the 1954 team the idea of finding genetically compatible donors to overcome the problem of rejection. 

Towards the early 1950s, dialysis was developing as a bridge treatment, but transplantation provided some hope of a cure to end-stage renal disease.

What was the Historical Procedure of the Kidney Transplant?

The historic operation was the case of 23-year-old Ronald Herrick who donated a kidney to his brother Richard Herrick, 24 years old, who had developed chronic glomerulonephritis. 

Dr. The surgery that was done to the recipient was headed by Joseph E. Murray, who was a plastic surgeon but the donor nephrectomy was done by the urologist Dr. J. Hartwell Harrison.

This operation took six hours to connect the kidney of the donor to the iliac vessels and bladder of Richard. It started to urinate at the operating table, and this was a good occurrence of immediate success. 

There was no need for immunosuppressive medication because the twins shared the same HLA which removed any chances of being rejected.

Who were the Key Figures?

Joseph E. Murray (1919-2012): Murray is a Harvard trained surgeon who shifted his focus to transplantation in place of reconstructive surgery. By 1962, he had organized more than 100 transplants and designed immunosuppression using azathioprine. Murray was awarded the 1990 Nobel Prize in Physiology or Medicine together with E. Donnall Thomas because of his works.

Supporting Team: Dr. J. Hartwell Harrison was in charge of donor safety; Dr. David Hume, the chief surgeon, was in charge of initial planning. The basic research on rejection by Peter Medawar led to his 1960 Nobel Prize, which indirectly gave Murray the success he had.

Outcomes and Impact

Richard Herrick led a normal life after the transplant, getting married, having two children and died in 1962 as a result of heart complications that were not related to the kidney. The donor, Ronald, was living a healthy life until the year 2010, when he was 79 years old.

This victory confirmed the transplantation with living donors, making them a global initiative. Since then, Brigham and Women Hospital has been able to carry out more than 2,700 kidney transplants. This was complemented by immunosuppressants such as cyclosporine (1980s) which opened up a choice to the unrelated donor and improved the five-year graft survival rate to more than 90% now.

Other Milestones

• 1959: Murray first transplanted non-identical twins with a kidney with total body irradiation.

• 1962: Azathioprine immunosuppression of the first deceased-donor kidney transplant.

• 1963: Minnesota First concomitant pancreas-kidney transplant.

• 1981: Approval of Cyclosporine significantly enhanced the results.

Global Scale (2018 data): The kidney transplants done around the world are estimated at about 95,000 with 36 percent being done using a living kidney donor.

In 1954, Murray won the case, and kidney failure ceased to be terminal, which led to heart, liver, and other organ shows. In the US alone, today waiting lists are over 100,000 and this highlights the continuous demands despite shortages. 

His moral focus on consent and innovation remains essential to the industry, and gene editing and xenotransplantation are the next areas.

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