caa a22 4500 475801865 CHVBK 20180406123739.0 cr unu---uuuuu 170329e20000701xx s 000 0 eng 10.1007/s002680010124 doi (NATIONALLICENCE)springer-10.1007/s002680010124 Starzl Thomas E. Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Falk Clinic, 4th Floor, 3601 Fifth Avenue, Pittsburgh, Pennsylvania 15213, USA, US aut History of Clinical Transplantation [Elektronische Daten] [Thomas E. Starzl] Abstract.: The emergence of transplantation has seen the development of increasingly potent immunosuppressive agents, progressively better methods of tissue and organ preservation, refinements in histocompatibility matching, and numerous innovations in surgical techniques. Such efforts in combination ultimately made it possible to successfully engraft all of the organs and bone marrow cells in humans. At a more fundamental level, however, the transplantation enterprise hinged on two seminal turning points. The first was the recognition by Billingham, Brent, and Medawar in 1953 that it was possible to induce chimerism-associated neonatal tolerance deliberately. This discovery escalated over the next 15 years to the first successful bone marrow transplantations in humans in 1968. The second turning point was the demonstration during the early 1960s that canine and human organ allografts could self-induce tolerance with the aid of immunosuppression. By the end of 1962, however, it had been incorrectly concluded that turning points one and two involved different immune mechanisms. The error was not corrected until well into the 1990s. In this historical account, the vast literature that sprang up during the intervening 30 years has been summarized. Although admirably documenting empiric progress in clinical transplantation, its failure to explain organ allograft acceptance predestined organ recipients to lifetime immunosuppression and precluded fundamental changes in the treatment policies. After it was discovered in 1992 that long-surviving organ transplant recipients had persistent microchimerism, it was possible to see the mechanistic commonality of organ and bone marrow transplantation. A clarifying central principle of immunology could then be synthesized with which to guide efforts to induce tolerance systematically to human tissues and perhaps ultimately to xenografts. by Société Internionale de Chirurgie, 2000 World Journal of Surgery Springer-Verlag 24/7(2000-07-01), 759-782 0364-2313 24:7<759 2000 24 268 https://doi.org/10.1007/s002680010124 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002680010124 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Starzl Thomas E. Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Falk Clinic, 4th Floor, 3601 Fifth Avenue, Pittsburgh, Pennsylvania 15213, USA, US aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/7(2000-07-01), 759-782 0364-2313 24:7<759 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer