Museum of Health Care Blog

In 1954 something incredible happened. What had once seemed impossible became a reality, setting the groundwork for one of the biggest revolutions in 20th-century medicine. This is the story of the first successful organ transplant. 

Now the intro to this piece is a bit misleading. Humanity has been performing organ transplants since antiquity. These surgeries have spanned the globe from Egypt to Rome to Greece, India and China.  The one thing all these transplants had in common is that they all dealt with the largest organs of the human body, skin. The oldest record of skin grafting is the “Ebers papyrus,” which dates to approximately 1500 BCE. The transplantation of internal organs was a much higher bar to clear, and the first internal organ transplants would have to wait until the 20th century. 

Many puzzle pieces needed to fall into place for transplantation to become a viable field of exploration. First, doctors needed to be able to perform safe and successful surgeries with high enough survival rates that undergoing experimental organ replacement seemed worth the risk. This hurdle was cleared in the mid to late 1800s with the invention of aseptic surgery, where surgeons started to maintain a sterile environment for surgery and the incorporation of anesthesia. Both of these practices allowed for lower mortality rates and more complex surgeries.

The next big barrier was that of blood transfusions. One significant risk of major procedures like organ transplants is blood loss, so physicians needed first to understand how to transfuse blood properly. Understanding blood types with the ABO system didn’t start until 1901; storing blood effectively with sodium citrate didn’t come into the picture until the 1910s and knowledge of negative and positive blood types with the Rh system didn’t arrive until the decades later. 

The last significant barrier to tackle was the immune response to organ transplants. This last roadblock was cleared with some exceptional circumstances in the case of the first transplant as it was done between twins. Still, later developments like immune-suppressing drugs would allow for broader applications. 

Early transplantation research started with the kidney because it was uniquely suited for experimentation in a way other organs were not. Most people are born with two kidneys but can survive with only one. This makes kidney donations much easier because they can occur between two living people. In 1933 the first kidney transplant was performed by the Ukrainian doctor Yurii Voronoy. It was ultimately unsuccessful, and the patient died two days later. It would take another 21 years for success to be achieved a continent away. 

The first successful kidney transplants started with a man named Richard Herrick. He was an active member of the Coast Guard who had to leave because he had chronic nephritis, a kidney condition which would eventually kill him if left untreated. He was a perfect candidate for an early transplant research because he had an identical twin. The immune response triggered by the transplantation of a new organ comes from the body’s recognition and rejection of a foreign object in the body. This response can be subverted in transplants between identical twins because the DNA in their tissue is the same. With the help of Dr. Joseph Murray, he underwent experimental surgery to replace his kidney with his twin’s on December 23, 1954. It was a success, and Herrick went on to live for another eight years. A little fun fact is that Herrick actually met his wife during his surgery; she was one of the nurses who helped in his operation. 

From this point, transplants start to take off. In 1959 the first transplant between non-identical participants happened. By the late 1960s, doctors had figured out how to transplant the liver, heart, and pancreas. Today the only major organ that can’t be transplanted is the brain. 

Richard Herrick’s transplant was a feat that could only have been accomplished because of decades of medical progress. His surgery is an excellent example of how most progress in medicine happens. There are only so many geniuses who change the whole trajectory of a field by themselves. Most revolutionary changes happen on the backs of everyday doctors, researchers and scientists who build on the successes and failures of those who came before them. This is the case for transplants just as it is the case for most medical history.