Developments in the clinical science of transplantation during the 20th century

Transplantation has become the treatment of choice for end-stage organ failure in the four and a half decades since the first successful kidney transplant procedure was performed in 1954. The achievements of solid organ transplantation can be gauged by the progressive increase in the number of kidney, liver, heart, pancreas and lung transplants that are performed annually. Advances in surgical technique, immunotherapy, control of opportunistic infections and tissue typing have collectively contributed to current 1-year patient survival rates that exceed 95% and current 1-year graft survival rates in excess of 85%. This paper will review some of the major advances that have lead to the current state of transplant immunobiology.