21 - Summary and Conclusion

Summary

Organ Transplantation as a Historical Topic

Virtually no one today would question the use of organ transplants to treat diseases. As universal as the concept might appear to us, however, transplant medicine in both theory and practice did not develop until the period between 1880 and 1930, and it did so only because of particular conditions in knowledge, technology, and society at the time. The history of the development of transplant medicine can be divided into two contrasting categories: the first is the emergence and dissemination of the concept of organ replacement; the second is the concept’s practical application. As a concept, organ replacement was a success in that it not only became generally accepted but also remained unchallenged as the conceptual basis on which doctors and scientists could build when they revived transplant surgery after 1945. In its practical application, however, organ replacement proved to be a failure during the first phase of its development, and surgical organ replacement was abandoned after 1930, not to be resumed until after World War II.

When it was developed in the 1800s, the concept of organ transplantation was new. Contrary to widespread assumption, transplantation had not been an age-old dream of mankind: no one had dreamt of transplanting organs before the 1880s. In fact, organ replacement therapy would have completely contradicted earlier conceptions of disease causation and treatment. The theoretical foundations for organ transplantation, along with the practical procedures for it, were only laid after 1880. To be sure, there had been rare instances of grafting living tissue earlier, but such transplants were performed in the context of repairing damage to the surface of the body and did not go beyond the limits of traditional surgery. Transplants had also been used as a research method in the natural sciences since the eighteenth century, but transplanting an organ to cure an internal disease by replacing the organ and thus restoring its function had not been done. This procedure represents a very special form of grafting; it is based on a distinctive rationale and must be distinguished from all earlier attempts at transplanting tissue.

The Origins of Organ Transplantation

From its beginnings, organ transplantation was associated with a specific notion of disease causation.