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Article
March 15, 1995

Transplantation MilestonesViewed With One- and Two-Way Paradigms of Tolerance

Author Affiliations

From the Pittsburgh (Pa) Transplantation Institute (Drs Starzl and Demetris) and the Departments of Surgery (Dr Starzl) and Pathology (Dr Demetris), University of Pittsburgh (Pa) Medical Center.

JAMA. 1995;273(11):876-879. doi:10.1001/jama.1995.03520350058029
Abstract

TEN YEARS ago in this journal's Landmark Article series of reproduced historical publications, the remarkable impact was described1 of the 1956 report in JAMA by Merrill et al2 of an identical twin renal transplantation. The operation was performed in December 1954, by Joseph E. Murray (Nobel Laureate, 1990) and his associates at the Peter Bent Brigham Hospital, Boston, Mass. By avoiding problems with rejection, such cases symbolized what might someday be accomplished if the immunologic reaction could be controlled. Then, on January 24, 1959, the barrier posed by genetic nonidentity was breached for the kidneys with a successful fraternal twin transplantation3 by the same team.

Over the ensuing 35 years, the beachhead has been expanded by the successful allotransplantation of the liver,4 heart,5 lung,6 pancreas,7 intestine,8 multiple abdominal viscera,9 and bone marrow.10,11 Such milestones are never eroded from the landscape, but

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