Kidney transplantation in Northern Ireland.
نویسندگان
چکیده
IT WAS shown by Ullmann as long ago as 1902 that it is possible to transplant the kidney of a dog from its normal site into the neck and renal function will result. He was also able to demonstrate that a kidney taken from another dog, or even from a goat, would also function, but he does not appear to have carried his experiments further. Carrel, working from 1905 to 1910, confirmed Ullmann's report that a kidney could be transplanted from the flank to the neck of the same dog (autotransplant) and would function satisfactorily. He also transplanted a kidney from a dog to a bitch (homotransplant), removing both of the bitch's own kidneys and initially the animal remained well with good kidney function but ultimately the transplanted kidney ceased to function. Almost another 50 years were to elapse before the first attempt to transplant a kidney into a human being was carried out in 1951 by Scola. This transplant was technically satisfactory, and the kidney produced some urine at first, but, as in the case of Carrel's dogs, the kidney was rejected after a short period. This operation however showed that in the human, as in the dog, it was technically feasible to transplant a kidney. Much research into the nature of the rejection process was carried out in both this country and the United States by Simonson, Dempster, and Murray, mainly by the study of the behaviour of skin grafts in mice. It had become clear that it ought to be possible to transplant kidneys without fear of rejection, between individuals whose genetic similarity was sufficiently close. The appreciation of this principle led to the first transplantation of a kidney between identical twins in Boston in 1954. This operation was successful and the kidney continued to function for eight years before the glomerulonephritis, which had been the original disease in the patient's own kidneys, attacked the transplanted organ and the patient died of coronary artery disease. Over the next five years attempts to transplant kidneys between identical twins were carried out at a number of centres both in America and Europe. Some of these transplants failed for technical reasons or because of sepsis but in none of them was there any evidence that the kidney was rejected. It is obvious that relatively few patients who reach end stage renal failure will be fortunate enough to have an identical twin who is able and willing to provide a kidney. There was therefore a considerable stimulus to develop a method of preventing rejection of the transplanted organ when kidneys were interchanged between less closely related individuals.
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ورودعنوان ژورنال:
- The Ulster Medical Journal
دوره 39 شماره
صفحات -
تاریخ انتشار 1970