Editing Organ transplantation (section)

== History ==
Successful human [[allotransplantation|allotransplants]] have a relatively long history of operative skills that were present long before the necessities for post-operative survival were discovered. [[Transplant rejection|Rejection]] and the side effects of preventing rejection (especially infection and [[nephropathy]]) were, are, and may always be the key problem.

Several apocryphal accounts of transplants exist well prior to the scientific understanding and advancements that would be necessary for them to have actually occurred. The [[Chinese people|Chinese]] physician [[Bian Que|Pien Chi'ao]] reportedly exchanged [[heart]]s between a man of strong spirit but weak will with one of a man of weak spirit but strong will in an attempt to achieve balance in each man. [[Catholic Church|Roman Catholic]] accounts report the 3rd-century saints [[Saint Damian|Damian]] and [[Saints Cosmas and Damian|Cosmas]] as replacing the [[gangrene|gangrenous]] or [[cancerous]] leg of the Roman deacon Justinian with the leg of a recently deceased [[Ethiopia]]n.<ref>{{Cite journal | last1 = Androutsos | first1 = G. | last2 = Diamantis | first2 = A. | last3 = Vladimiros | first3 = L. | title = The first leg transplant for the treatment of a cancer by Saints Cosmas and Damian | journal = Journal of the Balkan Union of Oncology | volume = 13 | issue = 2 | pages = 297–304 | year = 2008 | pmid = 18555483}}</ref><ref>{{cite book |url=http://www.fordham.edu/halsall/basis/goldenlegend/GoldenLegend-Volume5.asp |title=The Golden Ledent or Lives of the Saints |author=Jacobus de Voragine |year=1275 |access-date=24 December 2013}}</ref> Most accounts have the saints performing the transplant in the 4th century, many decades after their deaths; some accounts have them only instructing living surgeons who performed the procedure.

The more likely accounts of early transplants deal with skin transplantation. The first reasonable account is of the [[Indian people|Indian]] surgeon [[Sushruta]] in the 2nd century BC, who used autografted skin transplantation in nose reconstruction, a [[rhinoplasty]]. Success or failure of these procedures is not well documented. Centuries later, the [[Italy|Italian]] surgeon [[Gasparo Tagliacozzi]] performed successful skin autografts; he also failed consistently with [[allografts]], offering the first suggestion of rejection centuries before that mechanism could possibly be understood. He attributed it to the "force and power of individuality" in his 1596 work ''De Curtorum Chirurgia per Insitionem''.
[[File:Alexis Carrel nobel.jpg|thumb|150px|Alexis Carrel: 1912's Nobel Prize for his work on organ transplantation]]
The first successful corneal allograft transplant was performed in 1837 in a [[gazelle]] model; the first successful human corneal transplant, a [[Cornea transplant|keratoplastic]] operation, was performed by [[Eduard Zirm]] at [[Palacký University of Olomouc#Medicine and Dentistry|Olomouc Eye Clinic]], now in the [[Czech Republic]], in 1905.

The first transplant in the modern sense – the implantation of organ tissue in order to replace an organ function – was a [[thyroid]] transplant in 1883. It was performed by the [[Swiss people|Swiss]] surgeon and later [[Nobel laureate]] [[Theodor Kocher]]. In the preceding decades Kocher had perfected the removal of excess thyroid tissue in cases of [[goiter]] to an extent that he was able to remove the whole organ without the person dying from the operation. Kocher carried out the total removal of the organ in some cases as a measure to prevent recurrent goiter. By 1883, the surgeon noticed that the complete removal of the organ leads to a complex of particular symptoms that we today have learned to associate with a lack of thyroid hormone. Kocher reversed these symptoms by implanting thyroid tissue to these people and thus performed the first organ transplant. In the following years Kocher and other surgeons used thyroid transplantation also to treat thyroid deficiency that appeared spontaneously, without a preceding organ removal.

Thyroid transplantation became the model for a whole new therapeutic strategy: organ transplantation. After the example of the thyroid, other organs were transplanted in the decades around 1900. Some of these transplants were done in animals for purposes of research, where organ removal and transplantation became a successful strategy of investigating the function of organs. Kocher was awarded his [[Nobel Prize]] in 1909 for the discovery of the function of the thyroid gland. At the same time, organs were also transplanted for treating diseases in humans. The thyroid gland became the model for transplants of [[adrenal gland|adrenal]] and [[parathyroid gland]]s, pancreas, [[ovary]], [[testicle]]s and kidney. By 1900, the idea that one can successfully treat internal diseases by replacing a failed organ through transplantation had been generally accepted.<ref name="Schlich, Thomas 1930">{{cite book |last=Schlich |first=Thomas |title=The Origins of Organ Transplantation: Surgery and Laboratory Science |year=2010 |orig-year=originally published 1880–1930 |publisher=University of Rochester Press}}</ref> Pioneering work in the surgical technique of transplantation was made in the early 1900s by the [[French people|French]] surgeon [[Alexis Carrel]], with [[Charles Claude Guthrie|Charles Guthrie]], with the transplantation of [[artery|arteries]] or [[vein]]s. Their skillful [[anastomosis]] operations and the new suturing techniques laid the groundwork for later transplant [[surgery]] and won Carrel the 1912 [[Nobel Prize in Physiology or Medicine]]. From 1902, Carrel performed transplant experiments on [[dog]]s. Surgically successful in moving [[kidney]]s, [[heart]]s, and [[spleen]]s, he was one of the first to identify the problem of [[Transplant Rejection|rejection]], which remained insurmountable for decades. The discovery of transplant immunity by the [[Germans|German]] surgeon [[Georg Schöne]], various strategies of matching donor and recipient, and the use of different agents for immune suppression did not result in substantial improvement so that organ transplantation was largely abandoned after [[World War I|WWI]].<ref name="Schlich, Thomas 1930" />

In 1954, the first ever successful transplant of any organ was done at the Brigham & Women's Hospital in Boston. The surgery was performed by American surgeon [[Joseph Murray|Dr. Joseph Murray]], who received the Nobel Prize in Medicine for his work. The success of this transplant was mostly due to the family relation between the recipient, a Richard Herrick of Maine, and his donor and identical twin brother Ronald. Richard Herrick was in the Navy and became severely ill with acute renal failure. His brother Ronald donated his kidney to Richard, and Richard lived on for another eight years. Prior to this case, transplant recipients did not survive for more than thirty days. Their close family relation meant there was no need for anti-rejection medications, which was not known until this time, so the case shed light on the cause of rejection and of possible anti-rejection medicine.

Major steps in [[skin transplant]]ation occurred during the First World War, notably in the work of [[Harold Gillies]] at [[Aldershot]], [[United Kingdom]]. Among his advances was the tubed pedicle graft, which maintained a flesh connection from the donor site until the graft established its own [[blood]] flow. Gillies' assistant, [[Archibald McIndoe]], carried on the work into [[World War II|the Second World War]] as [[reconstructive surgery]]. In 1962, the first successful replantation surgery was performed – re-attaching a severed limb and restoring (limited) function and feeling.

Transplant of a single [[gonad]] (testis) from a living donor was carried out in early July 1926 in [[Zaječar]], [[Serbia]], by a [[Russians|Russian]] [[émigré]] surgeon Dr. Peter Vasil'evič Kolesnikov. The donor was a convicted murderer, one Ilija Krajan, whose death sentence was commuted to 20 years imprisonment, and he was led to believe that it was done because he had donated his testis to an elderly medical doctor. Both the donor and the receiver survived, but charges were brought in a court of law by the public prosecutor against Dr. Kolesnikov, not for performing the operation, but for lying to the donor.<ref>{{cite journal |url=http://tmg.org.rs/v290210.htm |title=Podmlađivanje hirurškim putem u Zaječaru 1926 |trans-title=Rejuvenation by surgery in Zajecar 1926 |journal=Timok Medical Journal |year=2004 |volume=29 |issue=2 |pages=115–17 |language=sr}}</ref>

The first attempted human deceased-donor transplant was performed by the [[Ukraine|Ukrainian]] surgeon [[Yurii Voronoy]] in the 1930s;<ref>{{cite journal |last1=Khadzhynov |first1=Dmytro |last2=Peters |first2=Harm |title=History of nephrology: Ukrainian aspects |journal=Kidney International |date=January 2012 |volume=81 |issue=1 |pages=118 |doi=10.1038/ki.2011.363 |doi-access=free }}</ref><ref>{{cite journal |title=Surgeon Yurii Voronoy (1895–1961) – a pioneer in the history of clinical transplantation: in memoriam at the 75th anniversary of the first human kidney transplantation |journal=Transplant International |date=December 2009 |volume=22 |issue=12 |pages=1132–39 |doi=10.1111/j.1432-2277.2009.00986.x |pmid=19874569 |vauthors=Matevossian E, Kern H, Hüser N, Doll D, Snopok Y, Nährig J, Altomonte J, Sinicina I, Friess H, Thorban S |s2cid=12087935 }}</ref> but failed due to [[ischemia]]. [[Joseph Murray]] and [[J. Hartwell Harrison]] performed the first successful transplant, a kidney transplant between identical [[twin]]s, in 1954, because no [[immunosuppression]] was necessary for genetically identical individuals.

In the late 1940s [[British people|British]] surgeon [[Peter Medawar]], working for the [[National Institute for Medical Research]], improved the understanding of rejection. Identifying the immune reactions in 1951, Medawar suggested that [[immunosuppressive drug]]s could be used. [[Cortisone]] had been recently discovered and the more effective [[azathioprine]] was identified in 1959, but it was not until the discovery of [[ciclosporin|cyclosporine]] in 1970 that transplant surgery found a sufficiently powerful immunosuppressive.

There was a successful deceased-donor [[lung]] transplant into an emphysema and [[lung cancer]] patient in June 1963 by [[James Hardy (surgeon)|James Hardy]] at the [[University of Mississippi Medical Center]] in [[Jackson, Mississippi]]. The patient John Russell survived for eighteen days before dying of [[kidney failure]].<ref name="JAMA, world's first lung transplant, 1963">{{cite journal |last1=Hardy |first1=James D. |last2=Webb |first2=Watts R. |last3=Dalton |first3=Martin L. |last4=Walker |first4=George R. |title=Lung Homotransplantation in Man: Report of the Initial Case |journal=JAMA |date=21 December 1963 |volume=186 |issue=12 |pages=1065–1074 |doi=10.1001/jama.1963.63710120001010 |pmid=14061414 }}</ref><ref>{{cite journal |last1=Griscom |first1=NT |title=Lung Transplantation |journal=JAMA |date=21 December 1963 |volume=186 |issue=12 |pages=1088 |doi=10.1001/jama.1963.03710120070015 |pmid=14061420 }}</ref><ref name="Anesthesia For Transplant Surgery, Sood and Vohra, 2014">[https://books.google.com/books?id=onSVAwAAQBAJ&q=%22lung+transplant%22+%22June+11%2C+1963%22&pg=PA4 Anesthesia for Transplant Surgery], Jayashree Sood, Vijay Vohra, New Delhi, London, Panama City, Philadelphia: Jaypee Brothers Medical Publishing, 2014, page 4, "Lung Transplant."</ref><ref name="Second Wind, Mary Jo Festle, 2012">[https://books.google.com/books?id=FeZeAQAAQBAJ&pg=PT72 Second Wind: Oral Histories of Lung Transplant Survivors], Mary Jo Festle, Palgrave MacMillan, 2012.</ref><ref name="UMMC (University of Mississippi Medical Center), Bruce Coleman, 2013">[https://www.umc.edu/News_and_Publications/Centerview/2013-05-13-04_Medical_Center_marks_50th_anniversary_of_momentous_surgical_achievement.aspx Medical Center marks 50th anniversary of momentous surgical achievement]{{Dead link|date=January 2019 |bot=InternetArchiveBot |fix-attempted=yes }}, University of Mississippi Medical Center, Bruce Coleman, 13 May 2013.  " ...  Rowland Medical Library ... restored film in canister No. 97 ... footage of Hardy's initial lung transplant follows – in vivid color.  .  "</ref>

[[Thomas Starzl]] of [[Denver]] attempted a liver transplant in the same year, but he was not successful until 1967.

In the early 1960s and prior to long-term dialysis becoming available, [[Keith Reemtsma]] and his colleagues at Tulane University in New Orleans attempted transplants of chimpanzee kidneys into 13 human patients.  Most of these patients only lived one to two months.  However, in 1964, a 23-year-old woman lived for nine months and even returned to her job as a school teacher until she suddenly collapsed and died.  It was assumed that she died from an acute electrolyte disturbance.  At autopsy, the kidneys had not been rejected nor was there any other obvious cause of death.<ref name="Brief History of Cross Species, Baylor Proceedings, 2012" /><ref>{{cite journal |last1=Reemtsma |first1=Keith |last2=McCracken |first2=B. H. |last3=Schlegel |first3=J. U. |last4=Pearl |first4=M. A. |last5=Pearce |first5=C. W. |last6=DeWitt |first6=C. W. |last7=Smith |first7=P. E. |last8=Hewitt |first8=R. L. |last9=Flinner |first9=R. L. |last10=Creech |first10=Oscar |title=Renal Heterotransplantation in Man |journal=Annals of Surgery |date=September 1964 |volume=160 |issue=3 |pages=384–408 |doi=10.1097/00000658-196409000-00006 |pmid=14206847 |pmc=1408776 }}</ref><ref name="Xenotransplantation, Cooper, Kemp, Reemtsma, White, 1991">[https://books.google.com/books?id=cKn9CAAAQBAJ&q=%22a+23-year-old+school+teacher+was+admitted+in+November+1963%22&pg=PA19 Xenotransplantation: The Transplantation of Organs and Tissues Between Species] edited and with chapters by David K.C. Cooper, Ejvind Kemp, Keith Reemtsma, and D.J.G. White; Berlin, Heidelberg, New York: Springer-Verlag, 1991.  Please see Case 2 on page 19 for discussion of the 1964 case of the 23-year-old school teacher who lived nine months after receiving a transplant of chimpanzee kidneys, which was written by her surgeon Keith Reemtsma.</ref> One source states this patient died from pneumonia.<ref name="Kidney Transplantation, Bioengineering, and Regeneration, Giuseppe Orlando, and others, 2017">[https://books.google.com/books?id=gv9PCwAAQBAJ&q=%22survived+for+9+months+following+transplantation+of+a+chimpanzee+kidney%22&pg=PA1154 Kidney Transplantation, Bioengineering, and Regeneration: Kidney Transplantation in the Regenerative Medicine Era], edited by Giuseppe Orlando, Giuseppe Remuzzi, David F. Williams, "Ch. 84.5 Xenotransplantation" by Kazuhiko Yamada, Masayuki Tasaki, Adam Griesemar, Jigesh Shah, London: Academic Press, 2017.</ref> Tom Starzl and his team in Colorado used baboon kidneys with six human patients who lived one or two months, but with no longer term survivors.<ref name="Brief History of Cross Species, Baylor Proceedings, 2012" /><ref>{{cite journal |last1=Stabzl |first1=T. E. |last2=Marchioro |first2=T. L. |last3=Peters |first3=G. N. |last4=Kiekpatrick |first4=C. H. |last5=Wilson |first5=W. E. C. |last6=Porter |first6=K. A. |last7=Rifkind |first7=D. |last8=Ogden |first8=D. A. |last9=Hitchcock |first9=C. R. |last10=Waddell |first10=W. R. |title=RENAL HETEROTRANSPLANTATION FROM BABOON TO MAN: EXPERIENCE WITH 6 CASES |journal=Transplantation |date=November 1964 |volume=2 |issue=6 |pages=752–776 |doi=10.1097/00007890-196411000-00009 |pmid=14224657 |pmc=2972727 }}</ref> Others in the United States and France had limited experiences.<ref name="Brief History of Cross Species, Baylor Proceedings, 2012" /><ref>{{cite journal |last1=Taniguchi |first1=S. |last2=Cooper |first2=D. K. |title=Clinical xenotransplantation: past, present and future. |journal=Annals of the Royal College of Surgeons of England |date=January 1997 |volume=79 |issue=1 |pages=13–19 |pmid=9038490 |pmc=2502626 }}</ref>

The heart was a major prize for transplant surgeons. But over and above rejection issues, the heart deteriorates within minutes of death, so any operation would have to be performed at great speed. The development of the [[heart-lung machine]] was also needed. Lung pioneer [[James Hardy (surgeon)|James Hardy]] was prepared to attempt a human heart transplant in 1964, but when a premature failure of comatose [[Boyd Rush]]'s heart caught Hardy with no human donor, he used a [[Common chimpanzee|chimpanzee]] heart, which beat in his patient's chest for approximately one hour and then failed.<ref name="JAMA 29 June 1964">{{cite journal | doi = 10.1001/jama.1964.03060390034008 | volume=188 | issue=13 | title=Heart Transplantation in Man | year=1964 | journal=JAMA |author1=Hardy, James D.|author2=Chavez, Carlos M.|author3=Kurrus, Fred D.|author4=Neely, William A.|author5=Eraslan, Sadan|author6=Turner, M. Don |author7=Fabian, Leonard W.|author8=Labecki, Thaddeus D.}}</ref><ref name="Every Second Counts, Donald McRae, 2006">''Every Second Counts: The Race to Transplant the First Human Heart'', Donald McRae, New York: Penguin (Berkley/Putnam), 2006, see Chapter 7 "Mississippi Gambling," [https://books.google.com/books?id=2Fv9dRT9TC4C&q=%22Hardy%20said%20he%20would%20ask%20each%20of%20them%20to%20vote%20in%20an%20informal%20poll%22&pg=PT110 pages 122 through 127].</ref><ref name="Brief History of Cross Species, Baylor Proceedings, 2012">{{cite journal | pmc = 3246856 | pmid=22275786 | volume=25 | issue=1 | title=A brief history of cross-species organ transplantation | author=Cooper DK | journal=Proc (Bayl Univ Med Cent) | pages=49–57| year=2012 | doi=10.1080/08998280.2012.11928783 }}  '[Regarding Hardy's 1964 transplant of chimpanzee heart into comatose patient, with a close relative signing the consent form] . . made no mention of the fact that an animal heart might be used for the procedure. Such was the medicolegal situation at that time that this "informed" consent was not considered in any way inadequate. . . '</ref> The first partial success was achieved on 3 December 1967, when [[Christiaan Barnard]] of [[Cape Town]], [[South Africa]], performed the world's first human-to-human heart transplant with patient [[Louis Washkansky]] as the recipient.  Washkansky survived for eighteen days amid what many{{Who|date=June 2012}} saw as a distasteful publicity circus. The media interest prompted a spate of heart transplants. Over a hundred were performed in 1968–1969, but almost all the people died within 60 days. Barnard's second patient, [[Philip Blaiberg]], lived for 19 months.

It was the advent of [[cyclosporine]] that altered transplants from research surgery to life-saving treatment. In 1968 surgical pioneer [[Denton Cooley]] performed 17 transplants, including the first [[heart-lung transplant]]. Fourteen of his patients were dead within six months. By 1984 two-thirds of all heart transplant patients survived for five years or more. With organ transplants becoming commonplace, limited only by donors, surgeons moved on to riskier fields, including multiple-organ transplants on humans and whole-body transplant research on animals. On 9 March 1981, the first successful heart-lung transplant took place at [[Stanford University]] Hospital. The head surgeon, [[Bruce Reitz]], credited the patient's recovery to [[cyclosporine]].

As the rising success rate of transplants and modern [[immunosuppression]] make transplants more common, the need for more organs has become critical. Transplants from living donors, especially relatives, have become increasingly common. Additionally, there is substantive research into [[xenotransplantation]], or transgenic organs; although these forms of transplant are not yet being used in humans, clinical trials involving the use of specific [[cell (biology)|cell]] types have been conducted with promising results, such as using [[pig|porcine]] [[islets of Langerhans]] to treat [[type 1 diabetes]]. However, there are still many problems that would need to be solved before they would be feasible options in people requiring transplants.

Recently, researchers have been looking into means of reducing the general burden of immunosuppression. Common approaches include avoidance of steroids, reduced exposure to [[calcineurin]] inhibitors, increased coverance of [[vaccination]] for [[Vaccine-preventable disease]]<ref>Costantino, A.; Invernizzi, F.; Centorrino, E.; Vecchi, M.; Lampertico, P.; Donato, M.F. COVID-19 Vaccine Acceptance among Liver Transplant Recipients. Vaccines 2021, 9, 1314. https://doi.org/10.3390/vaccines9111314</ref><ref>Costantino, A.; Morlacchi, L.; Donato, M.F.; Gramegna, A.; Farina, E.; Dibenedetto, C.; Campise, M.; Redaelli, M.; Perego, M.; Alfieri, C.; et al. Hesitancy toward the Full COVID-19 Vaccination among Kidney, Liver and Lung Transplant Recipients in Italy. Vaccines 2022, 10, 1899. https://doi.org/10.3390/vaccines10111899</ref> and other means of weaning drugs based on patient outcome and function. While short-term outcomes appear promising, long-term outcomes are still unknown, and in general, reduced immunosuppression increases the risk of rejection and decreases the risk of infection. The risk of early rejection is increased if [[corticosteroid]] immunosuppression are avoided or withdrawn after renal transplantation.<ref>{{cite journal |last1=Haller |first1=Maria C |last2=Royuela |first2=Ana |last3=Nagler |first3=Evi V |last4=Pascual |first4=Julio |last5=Webster |first5=Angela C |title=Steroid avoidance or withdrawal for kidney transplant recipients |journal=Cochrane Database of Systematic Reviews |date=22 August 2016 |volume=2016 |issue=8 |pages=CD005632 |doi=10.1002/14651858.CD005632.pub3 |pmc=8520739 |pmid=27546100 |hdl-access=free |hdl=1854/LU-8083451}}</ref>

Many other new drugs are under development for transplantation.<ref>[https://web.archive.org/web/20070810075505/http://www.ebmt.org/6NursesGroup/NGdocs/Education2007/Drugs_C_Paillet.pdf New Drugs in Transplantation], EBMT Meeting, France, March 2007 C. Paillet, Pharmacist, Pharm D. C. Renzullo, Pharmacist, Pharm D. Edouard Herriot Hospital, Lyon, France</ref>
The emerging field of [[regenerative medicine]] promises to solve the problem of organ transplant rejection by regrowing organs in the lab, using person's own cells (stem cells or healthy cells extracted from the donor site).

=== Timeline of transplants ===
* 1869: First skin autograft-transplantation by Carl Bunger, who documented the first modern successful [[skin graft]] on a person. Bunger repaired a person's nose destroyed by [[syphilis]] by grafting flesh from the inner thigh to the nose, in a method reminiscent of the ''[[Sushrutha]]''.
* 1905: First successful cornea transplant by [[Eduard Zirm]] (Czech Republic)
* 1908: First skin allograft-transplantation of skin from a donor to a recipient (Switzerland)
* 1931: First uterus transplantation ([[Lili Elbe]]).
* 1950: First successful kidney transplant by Dr. [[Richard H. Lawler]] ([[Chicago]], US)<ref name="Lawler">{{cite news |url=https://www.nytimes.com/1982/07/27/obituaries/rh-lawler-pioneer-of-kidney-transplants.html |title=R.H. Lawler, Pioneer of Kidney Transplants |date=27 July 1982 |newspaper=The New York Times|access-date=25 December 2013}}</ref>
* 1954: First living related kidney transplant ([[identical twins]]) (US)<ref>{{cite web |url=https://www.pbs.org/wgbh/aso/databank/entries/dm54ki.html |title=A Science Odyssey: People and Discoveries: First successful kidney transplant performed |publisher=[[PBS]] |access-date=25 December 2013}}</ref>
* 1954: Brazil's first successful corneal transplant, the first liver (Brazil)
* 1955: First [[heart valve]] allograft into descending [[aorta]] (Canada)
* 1963: First successful lung transplant by [[James Hardy (surgeon)|James D. Hardy]] with patient living 18 days (US)
* 1964: [[James Hardy (surgeon)|James D. Hardy]] attempts heart transplant using chimpanzee heart (US)
* 1964: Human patient lived nine months with chimpanzee kidneys, twelve other human patients only lived one to two months, Keith Reemtsma and team (New Orleans, US)
* 1965: [[Spain]]'s first successful kidney transplant at [[Hospital Clínic de Barcelona|Hospital Clinic]] de [[Barcelona]], [[Catalonia]], [[Spain]], by a [[surgeon]] team led by Josep Maria Gil-Vernet and Antoni Caralps. The patient, a woman, had a very long life since the procedure.<ref>{{cite web | url=https://sctransplant.org/pioneng.html| title=Transplantation: Catalan pioneers|access-date=10 December 2022}}</ref>
* 1965: Australia's first successful (living) kidney transplant ([[Queen Elizabeth Hospital, Adelaide|Queen Elizabeth Hospital]], [[South Australia|SA]], Australia)
* 1966: First successful pancreas transplant by [[Richard C. Lillehei]] and William Kelly ([[Minnesota]], US)
* 1967: First successful liver transplant by [[Thomas Starzl]] (Denver, US)
* 1967: First successful heart transplant by [[Christiaan Barnard]] (Cape Town, South Africa)
* 1978 Use of ciclosporin in clinical renal transplants<ref>Roy Calne. Essay History of transplantation. Lancet 2006; 368: S51–S52</ref>
* 1981 Use of monoclonal antibodies to lymphocytes in organ grafting
* 1981: First successful heart/lung transplant by [[Bruce Reitz]] (Stanford, US)
* 1983: First successful lung lobe transplant by [[Joel D. Cooper|Joel Cooper]] at the [[Toronto General Hospital]] ([[Toronto]], Canada)
* 1984: First successful double organ transplant by [[Thomas Starzl]] and Henry T. Bahnson ([[Pittsburgh]], US)
* 1986: First successful double-lung transplant ([[Ann Harrison (lung transplant recipient)|Ann Harrison]]) by [[Joel D. Cooper|Joel Cooper]] at the [[Toronto General Hospital]] (Toronto, Canada)
* 1990: First successful adult segmental living-related liver transplant by [[Mehmet Haberal]] (Ankara, Turkey)
* 1992: First successful combined liver-kidney transplantation from a living-related donor by [[Mehmet Haberal]]{{Citation needed|date=January 2023}} (Ankara, Turkey)
* 1995: First successful [[Laparoscopic surgery|laparoscopic]] live-donor nephrectomy by Lloyd Ratner and Louis Kavoussi ([[Baltimore]], US)
* 1997: First successful allogeneic vascularized transplantation of a fresh and perfused human [[knee]] joint by [[Gunther O. Hofmann]]
* 1997: Illinois' first living donor kidney-pancreas transplant and first robotic living donor pancreatectomy in the US. [[University of Illinois Medical Center]]
* 1998: First successful live-donor partial [[pancreas transplant]] by David Sutherland (Minnesota, US)
* 1998: First successful hand transplant by Dr. [[Jean-Michel Dubernard]] ([[Lyon]], France)
* 1998: United States' first adult-to-adult living donor liver transplant [[University of Illinois Medical Center]]
* 1999: First successful tissue engineered [[bladder]] transplanted by [[Anthony Atala]] ([[Boston Children's Hospital]], US)
* 2000: First robotic donor nephrectomy for a living-donor kidney transplant in the world [[University of Illinois Medical Center]]
* 2004: First liver and small bowel transplants from same living donor into same recipient in the world [[University of Illinois Medical Center]]
* 2005: First successful ovarian transplant by Dr. P. N. Mhatre (Wadia Hospital, [[Mumbai]], India)
* 2005: First successful partial [[face transplant]] (France)
* 2005: First robotic hepatectomy in the United States [[University of Illinois Medical Center]]
* 2006: Illinois' first paired donation for ABO incompatible kidney transplant [[University of Illinois Medical Center]]
* 2006: First [[jaw]] transplant to combine donor [[jaw]] with [[bone marrow]] from the patient, by [[Eric M. Genden]] ([[Mount Sinai Hospital, New York|Mount Sinai Hospital]], [[New York City]], US)
* 2006: First successful human [[penis transplant]] (later reversed after 15 days due to 44-year-old recipient's wife's psychological rejection) ([[Guangzhou]], China)<ref>{{cite news |url=https://www.theguardian.com/science/2006/sep/18/medicineandhealth.china |work=The Guardian |location=London |title=Man rejects first penis transplant |first=Ian |last=Sample |date=18 September 2006 |access-date=22 May 2010}}</ref><ref>{{cite journal |title=A preliminary report of penile transplantation |year=2006 |journal=European Urology |pages=851–53 |volume=50 |issue=4 |doi=10.1016/j.eururo.2006.07.026 |pmid=16930814 |last1=Hu |first1=W |last2=Lu |first2=J |last3=Zhang |first3=L |last4=Wu |first4=W |last5=Nie |first5=H |last6=Zhu |first6=Y |last7=Deng |first7=Z |last8=Zhao |first8=Y |last9=Sheng |first9=W |last10=Chao |first10=Q |last11=Qiu |first11=X |last12=Yang |first12=J |last13=Bai |first13=Y}}</ref>
* 2008: First successful complete full double [[arm]] transplant by Edgar Biemer, Christoph Höhnke and Manfred Stangl ([[Technical University of Munich]], Germany)
* 2008: First baby born from transplanted ovary. The transplant was carried out by Dr Sherman Silber at the Infertility Centre of St Louis in Missouri. The donor is her twin sister.<ref>{{cite news |title=Woman to give birth after first ovary transplant pregnancy |url=https://www.theguardian.com/science/2008/nov/09/health|newspaper=The Guardian |date=9 November 2008|last1=Randerson|first1=James}}</ref>
* 2008: First transplant of a [[Vertebrate trachea|human windpipe]] using a patient's own stem cells, by [[Paolo Macchiarini]] ([[Barcelona]], Spain)
* 2008: First successful transplantation of near total area (80%) of [[face transplant|face]], (including [[palate]], [[nose]], [[cheeks]], and [[eyelid]]) by [[Maria Siemionow]] ([[Cleveland Clinic]], US)
* 2009: Worlds' first robotic kidney transplant in an obese patient [[University of Illinois Medical Center]]
* 2010: First full facial transplant by Dr. Joan Pere Barret and team (Hospital Universitari Vall d'Hebron on 26 July 2010, in [[Barcelona]], Spain)
* 2011: First double leg transplant by Dr. Cavadas and team (Valencia's Hospital, La Fe, Spain)
* 2012: First simultaneous robotic bariatric surgery (sleeve gastrectomy) and kidney transplantation (university of Illinois at Chicago).  ([https://chicago.medicine.uic.edu/wp-content/uploads/sites/6/2018/06/The-Cutting-Edge-Fall-2012.pdf#:~:text=By%20simultaneously%20undergoing%20two%20procedures%E2%80%94robotic-assisted%20kidney%20transplantation%20and,Surgeons%20can%20utilize%20the%20same%20minimally%20invasive%20incisions/ 1]).  ([https://today.uic.edu/first-simultaneous-robotic-kidney-transplant-sleeve-gastrectomy-performed/ 2])
* 2012: First Robotic Alloparathyroid transplant. University of Illinois Chicago
* 2013: First successful entire face transplantation as an urgent life-saving surgery at [[Curie Institute, Warsaw|Maria Skłodowska-Curie Institute of Oncology]] branch in [[Gliwice]], Poland.<ref>{{cite news |title=Polish man gets quick face transplant after injury |url=https://news.yahoo.com/polish-man-gets-quick-face-transplant-injury-154622336.html |work=Yahoo! News |date=22 May 2013 |access-date=29 May 2013}}</ref>
* 2014: First successful uterine transplant resulting in live birth (Sweden)
* 2014: First successful penis transplant. (South Africa)<ref>{{cite web|url=http://www.cnn.com/2015/03/13/health/penis-transplant-south-africa/|author=Joseph Netto|title=Doctors claim first successful penis transplant|date=13 March 2015|publisher=CNN}}</ref>
* 2014: First neonatal organ transplant. (UK)<ref>{{cite news|url=https://www.thetimes.com/travel/destinations/uk-travel/newborn-baby-is-youngest-organ-donor-in-britain-hw0pnw90mxf|author=Kat Lay|title=Newborn baby is youngest organ donor in Britain|newspaper=[[The Times]]|location=U.K.|date=20 January 2015}}</ref>
* 2018: Skin gun invented, which takes a small amount of healthy skin to be grown in a lab, then is sprayed onto burnt skin. This way skin will heal in days instead of months and will not scar.
* 2019: First [[Delivery drone|drone delivery]] of a donated kidney, that was then successfully transplanted into a patient. (US)<ref>{{cite news|url=https://www.cnn.com/2019/05/01/health/drone-organ-transplant-bn-trnd/index.html|author=Susan Scutti|title=First drone delivery of a donated kidney ends with successful transplant|newspaper=CNN|location=U.S.|date=1 May 2019}}</ref>
* 2021: First transplant of both arms and shoulders performed on an Icelandic patient at the Édouard Herriot Hospital. (FR)<ref>{{cite news|url=https://www.sciencesetavenir.fr/sante/os-et-muscles/double-greffe-du-bras-et-des-epaules-a-lyon-une-premiere-mondiale_150843|author=Sciences et Avenir with AFP|title=Double greffe des bras et des épaules à Lyon, une première mondiale|newspaper=Sciences et Avenir|location=France|date=15 January 2021}}</ref>
* 2022: First successful heart transplant from a pig to a human patient. (US)<ref>{{cite news|url=https://www.umms.org/ummc/news/2022/first-successful-transplant-of-porcine-heart-into-adult-human-heart|title=University of Maryland School of Medicine Faculty Scientists and Clinicians Perform Historic First Successful Transplant of Porcine Heart into Adult Human with End-Stage Heart Disease|newspaper=University of Maryland Medical Center|location=U.S|date=10 January 2022}}</ref> The recipient later died as the pig's heart was infected with porcine cytomegalovirus.<ref>{{cite web|url=https://www.theguardian.com/us-news/2022/may/06/man-landmark-pig-heart-transplant-death-pig-virus|author=Maya Yang|title= Man who received landmark pig heart transplant died of pig virus, surgeon says|date=6 May 2022|work=The Guardian}}</ref>
* 2023: First main pulmonary artery transplant to extend cancer treatment possibility by Prof. Stefano Cafarotti and team (Ente Ospedaliero Cantonale, Lugano - Switzerland)<ref name="Ambrogi2023">{{cite journal|access-date=11 April 2025 |date=3 April 2023 |doi=10.1093/ejcts/ezad127 |first=Marcello Carlo |first2=Vittorio |first3=Marco |language=en |last=Ambrogi |last2=Aprile |last3=Lucchi |magazine=European Journal of Cardio-Thoracic Surgery |number=4 |title=Surgery for advanced thymic malignancies: how far can we push the limit? |url=https://academic.oup.com/ejcts/article/doi/10.1093/ejcts/ezad127/7108864 |volume=63|doi-access=free }}<!-- auto-translated from Italian by Module:CS1 translator --></ref><ref name="Cafarotti2023">{{cite journal|access-date=11 April 2025 |date=April 2023 |doi=10.1093/ejcts/ezad069 |first=Stefano |first2=Tiziano |first3=Miriam |first4=Stefanos |language=en |last=Cafarotti |last2=Torre |last3=Patella |last4=Demertzis |magazine=European Journal of Cardio-Thoracic Surgery |number=4 |pmid=36852845 |title=Resection of thymic carcinoma after induction therapy and reconstruction of right ventricular outflow tract with pulmonary homograft |url=https://doi.org/10.1093/ejcts/ezad069 |volume=63|doi-access=free }}<!-- auto-translated from Italian by Module:CS1 translator --></ref><ref>{{cite web|access-date=19 April 2025 |date=12 April 2023 |publisher=Radiotelevisione svizzera |title=Prima mondiale al Cardiocentro |url=https://www.rsi.ch/news/ticino-e-grigioni-e-insubria/Prima-mondiale-al-Cardiocentro-15871984.html |website=RSI News}}<!-- auto-translated from Italian by Module:CS1 translator --></ref><ref>[https://www.bluewin.ch/it/attualita/regionali/prima-mondiale-al-cardiocentro-1251824.html Bluewin. "Prima mondiale al Cardiocentro"]</ref><ref>[https://www.tio.ch/ticino/attualita/1588406/intervento-cardiocentro-tumore-arteria-petto Ticinonews. "Intervento al Cardiocentro per un tumore all'arteria polmonare"]</ref><ref>[https://www.cardiocentro.org/it/press/un-intervento-straordinario-al-cardiocentro Cardiocentro. "Un intervento straordinario al Cardiocentro"]</ref><ref>[https://www.pr.com/press-release/936276 PR.com. "Press release: World-first lung artery transplant at Cardiocentro"]</ref><ref>{{cite web|date=18 April 2025 |language=en |title=World-First Pulmonary Artery Transplant Performed In Thymic Carcinoma Case By Professor Stefano Cafarotti |url=https://www.benzinga.com/pressreleases/25/04/r44800812/world-first-pulmonary-artery-transplant-performed-in-thymic-carcinoma-case-by-professor-stefano-ca |website=Benzinga}}<!-- auto-translated from Italian by Module:CS1 translator --></ref><ref>{{cite web|access-date=24 April 2025 |author=Robert Krcmar |date=8 June 2022 |language=it |title=Un intervento unico al mondo al Cardiocentro |url=https://www.tio.ch/ticino/attualita/1588406/intervento-cardiocentro-tumore-arteria-petto |website=tio.ch}}<!-- auto-translated from Italian by Module:CS1 translator --></ref>