Transplants: From “Unethical” to Miracle, and Beyond
Education & Research The first transplant professionals were revolutionary in their approach, and we need to retain that pioneering spirit via medical research and innovation.
The field of transplantation has come a long way since the first successful kidney transplant was carried out at the Brigham and Women’s Hospital, Boston in 1954. The procedure was hailed as a miracle, and for his efforts and on behalf of his team, Dr. Joseph Murray was awarded a Nobel Prize in Medicine in 1990. Through that experience, and the hard work and persistence of many dedicated researchers and clinicians, heart, liver, lung and even hand and face transplants are now possible.
Road to standardization
However, in the early days of transplantation, many of the procedures we now take for granted were viewed by some as unethical, as the rate of survival of the patients was limited or the risks of complications were viewed as being too great. In many ways, it is a real turnaround that today transplantation is viewed as a huge success, as of course it is.
What is less well understood and recognized is that transplantation could and should be more successful: many kidney transplant recipients are transplanted two, three or more times, as their transplants wear out; the average survival for a lung transplant recipient is only just over five years; islet cell transplants used to treat Type 1 diabetics fail because of the inability to protect the transplant from an immune response. In short, the field of transplantation could be enhanced to help millions more people if research in this area were accelerated.
“It is a real turnaround that today transplantation is viewed as a huge success, as of course it is.”
Solving our immune system
The term “one transplant for life” was coined to represent the idea of tolerance, an approach whereby the body’s specific immune response to a transplant could be turned off without the need for lifelong medication. While the idea of tolerance remains to be perfected, “one transplant for life” should also be a rallying cry to promote more investigation in the transplant field that focuses on all aspects of research that would increase organ availability and, just as importantly, foster longer transplant survival.
Initiatives such as the recent White House Summit on transplantation, which highlighted areas of research within the field of transplantation, as well as the “Power to Save” initiative, recently launched to promote research in the field of transplantation, will be key in raising awareness to continue to make progress. By developing a new generation of safer and more effective medications, optimizing medication therapies and creating the best environment for the transplanted organ, we can transform transplantation from a treatment to a cure.