Organ and tissue transplantation: past, present and future

Organ and tissue transplantation are now clinical treatment options for irreversible failure of many organs and systems. Living related donors or cadaver donors are used in kidney transplantation and it is a well-established procedure with defined results. Cardiac graft results match those obtained for recipients of unrelated kidney grafts from cadavers. Combined heart and lung grafts have been successfully used to treat cor pulmonale. Liver transplantation is technically demanding, and suffers from the absence of effective liver-support systems, but can achieve lifesaving short-term and long-term survival in selected patients. Pancreatic transplantation offers great potential, but long-term results both of isolated islet-cell transplantation and of organ grafts have been disappointing. Lung transplantation as an isolated procedure has had very little success. Bone-marrow transplantation is now the method of choice of treatment of aplastic anaemia, and is occasionally successful in management of malignancies. Transplantation of skin, bone, cartilage, endocrine, and vascular tissues has a variety of important clinical applications. Corneal transplantation has the longest successful history of all allografts.