Kidney Transplantation 1954 – A Nobel Prize-Winning Operation

Centuries ago, the kidneys were held in particular reverence. According to the Jewish Talmud, "A person has two kidneys: one prompts him toward good and the other toward evil" (Berakhoth 61a). 

In 1954, American surgeon Joseph Murray and colleagues performed the first successful kidney transplant between male twins, one the donor and the other the recipient. Before the operation, Murray had been told that kidney transplants were "impossible" and that he "should not play God." In 1990, Murray won the Nobel Prize for his achievements in transplantation.

The groundbreaking organ transplants of the 1950s built on earlier work by French surgeon Alexis Carrel, a pioneer of vascular suturing, and British surgeon Peter Medawar's research into immune rejection of skin grafts. Organ transplantation between unrelated people was not safe until immunosuppressive drugs became available to prevent the recipient's immune system from rejecting the foreign organ's tissue. Two examples of immunosuppressants discovered were:

• Azathioprine – 1962 
• Cyclosporine – 1972

Conditions such as high blood pressure and diabetes can arise from problems involving the kidneys. Dialysis can replace kidney functions, but patients generally live longer with a transplanted kidney. During transplantation, the patient's own poorly functioning kidney is usually left in place. The new kidney is transplanted into the lower abdomen and connected to the iliac artery and vein, while the donor ureter is connected to the bladder.

The kidneys play a role in transferring waste products to the bladder as urine and regulating electrolyte concentrations in the blood. They also secrete hormones:

• Erythropoietin – stimulates the bone marrow to produce red blood cells
• Renin – regulates blood pressure
• Calcitriol – the active form of vitamin D, which helps maintain calcium levels

Historical Figures Mentioned in This Article: Alexis Carrel (1873–1944), Peter Brian Medawar (1915–1987), Joseph Edward Murray (b. 1919)

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