What Is Special about Organ Transplantation?

Summary

The practice of transplanting living tissue was not limited to the transplantation of organs. Moving living tissue from one place to another was of interest in a number of different contexts. One of them was surgery. Being responsible for the treatment of wounds, surgeons had an inherent interest in the question of how to make separate parts of living organisms grow together. They were also interested in the more specific question of whether living tissue was transplantable because transplants could be used to patch up injuries on the surface of the body, an approach that eventually became the domain of the specialized field of plastic surgery. Similarly, vascular surgeons and eye specialists were also concerned with repairing body structures and they too explored the question of the transplantability of living tissues. These practical concerns led some surgeons and scientists to develop a broader theoretical interest in the underlying principles of transplantability. Clarifying these principles was the primary concern of researchers in the life sciences—biology, physiology, and to some extent pathology. These scientists used transplantation as a method for conducting general research into the basic principles of life processes.

Transplantation as a Traditional Surgical Practice

Traditionally, the treatment of injuries and the correction of anomalies on the body’s surface and in its orifices were central to a surgeon’s professional responsibilities. From the Middle Ages to the late eighteenth century, medical knowledge and practice were split into surgery on the one hand and (internal) medicine on the other. In the Western world, both the training and the professional organization of surgeons and doctors differed considerably. The same was true for their respective professional domains: surgeons were, in principle (though not always in practice), limited to locally circumscribed interventions on the body’s surface. In their work they were, as a rule, subordinate to the directives of doctors, who, by virtue of their university-based training, claimed to have a better understanding of physical processes as a whole.

One of the basic responsibilities of this traditional kind of surgeon was what we would now call plastic surgery. In this context, surgical literature dealt repeatedly with the grafting of tissue to restore mutilated parts of the body.