The History of Renal Transplantation

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The History of Renal Transplantation

• R. Margreiter
• Univ.-Klinik für Visceral-, Transplantations- und
  Thoraxchirurgie
• Department für Operative Medizin
• Medizinische Universität Innsbruck

Vienna, 11.12.2009
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Experimental Transplantation
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• Alfred von Lexer 1895
• Vienna
• Early vascular thrombosis?
• Lesky E Münch. Med. Wschr. 116, 1081 (1974)
• Alfred von Decastello-Rechtwehr 21.12.1899
• Vienna
• 1200 cc urine, died after 40 hours (hemorrhage)
• Decastello Av Wien. Klin. Wschr. 15, 317 (1902)

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Experimental Transplantation
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• Emerich Ullmann
• Vienna
• 7 March 1902 Report on first
  successful kidney
• transplant
• autotransplant to neck-vessels (dog)
• cuff technique
• function for 5 days
• Ullmann E Wien. Klin. Wschr. 11,281 (1902)

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Experimental Transplantation
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• Alexis Carrel
• 1905
• renal transplants with vascular anastomoses
• Carrel A Science 22, 473 (1905)

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Experimental Transplantation
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• R. Stich
• 1907
• autotransplants
• uretero-neocystostomy
• Stich R Arch. Klin. chir. 83, 494 (1907)

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Clinical Transplantation
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• M. Jaboulay
• 24.01.1906 pig kidney gt 48y female
• 09.04.1906 goat kidney gt 50y female
• Implantation site elbow
• function no
• died after 3 and 9 days
• Jaboulay M Lyon Med. 107, 575 (1906)

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Clinical Transplantation
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• Ernst Unger
• 1910
• en bloc subhuman primate kidneys gt
• female 21y
• implantation site tigh
• function no
• outcome died after 32 hours
• Unger E Berl. Klin. Wschr. 573 13 (1910)

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Clinical Transplantation
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• M. Neuhof
• 1923
• sheep kidney gt 48y male
• function no
• outcome died day 9
• Neuhof H Transplantation of tissues,
  Appleton, New York (1923)

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Clinical Transplantation
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• Yuri Voronoy
• 1933
• donor trauma victim, blood
  group B
• recipient 37y male, blood group
  0 mercury poisoning
• warm ischemia 6 hours
• implantation site tigh
• function no
• outcome died after 48 hours
• 4 further transplants
• Hamilton D.N.H., Reid W.A YoYo Voronoy and the
  first human kidney allograft Surg. Gyn. Obst.
  159,289 (1954)

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Clinical Transplantation
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• Landsteiner, Hufnagel
• 1945
• recipient 36y female, acute renal
  failure
• implementation site elbow
• function no
• outcome survived
• graft removed after 48 hours
• Cited Hume D.M. J. Clin. Invest. 34, 327 (1955)

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Clinical Transplantation
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• R.H. Lawler et al
• 17.6.1950
• donor woman 49y blood group AB
• hemorrhages from esophageal
  varices
• recipient woman 44y blood group AB
• polycystic kidney disease (Cr.
  1.8 mg)
• implantation site orthotopic, left
• ureteroureterostomy
• function yes
• outcome Cr. 1.2 mg
• no function at month 9
• R.H. Lawler et al JAMA 144, 844 (1950)

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Clinical Transplantation
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The free kidneys in those days came from
children with hydrocephalos, who had one kidney
removed (Matsons procedure) to use the ureter
from drainage of the catheter from the brain.

• R. Küss
• C. Dubost
• U. Servelle
• 1951 live donors
• implantation site iliac fossa
• function partial
• outcome no longterm survivor
• Küss R. et al Mem. Acad. Chir. 77, 755 (1951)
• Dubost C. et al Bull. Soc. Med. Hop. Paris 67,
  1372 (1951)
• Sevelle U. et al Bull. Soc. Med. Hop. Paris 67,
  99 (1951)

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Clinical Transplantation
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• D.M. Hume (1917-1973)
• 1952-1953
• 10 transplants
• implantation sitetigh
• life sustaining function for 6 months
• Hume D.M. et al J. Clin. Invest. 34, 327 (1955)

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Clinical Transplantation
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L. Michon 1953 donor mother recipient male
16y function 22 days outcome died day
23 Michon L et al Presse Med. 61 1419 (1953)
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Clinical Transplantation
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J. Murray 23/12/1954 donor monozygotic
twin implantation site iliac fossa
uretero-neocystostomy function
excellent outcome died at 8 years
(myocardial infarction)
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First Successfull Kidney TransplantDecember
23rd, 1954
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