Organ Transplantation in Times of Donor Shortage. An Introduction

Abstract

Organ transplantation is an exceptional success story of modern medicine. From 1954, when Joseph E. Murray conducted the first living kidney donation among twins, to 2013, when 6866 transplants were conducted within the Eurotransplant region, the new discipline of transplantation medicine has been confronted with a long list of different challenges and obstacles. In the beginning, medical difficulties were in the foreground, e.g. tissue typing or the matching of donors and suitable recipients. One of the major problems, the allogeneic rejection caused by antigen differences, was able to be solved in the course of the 1950s. Due to the groundbreaking discovery of the French hematologist Jean Dausset, who in 1958 discovered that Human Leukocyte Antigens (HLA) function as body markers indicating whether a tissue is own or foreign, it became possible to develop immunosuppressive drugs which counteract rejection. Based on the development of more specific and effective immunosuppressants, transplantation technology could expand. Thereby the 1960s became the decade of transplantation success with the first post-mortem kidney transplantation in 1962, the first liver and lung transplantations in 1963, followed by the first pancreas and the first heart transplantations in 1966 and 1967, respectively.