Medical and ethical challenges during the first successful human kidney transplantation in 1954 at Peter Bent Brigham Hospital, Boston.

Abstract

The first successful major organ transplantation, a kidney transplant, took place on December 23, 1954, at Peter Bent Brigham Hospital, Boston, Massachusetts. This was the beginning of major organ transplants commonly performed today, heralding one of the most significant achievements of medicine. A half-century later, heart, liver, limb, and even face transplants have become standard practice. In this report, we explore details of the preparations, the ethical dilemmas and the unknowns, and how these issues were addressed and overcome. Published works, hospital records, personal notes, and conversations with the individuals who participated in this event allowed us a unique opportunity to collect, analyze, and interpret the events. Several factors converged at Peter Bent Brigham Hospital to enable success. The department chair in medicine was committed to studying renal hypertension who then recruited others to work in this area. The department chair in surgery was committed to research, including making research results clinically useful. The chair of the anesthesia division was a technically skilled clinician, able to manage a previously unknown procedure. Finally, a suitable candidate for kidney transplant happened to have an identical twin brother, eliminating the issue of possible rejection. These factors aligned at the right time and place to transplant the first human kidney. Medical and ethical challenges dominated the scene of the first successful major organ transplant, which began the remarkable advance in transplant medicine, an advance that occurred very rapidly between 1947 and 1951.