The history of kidney transplantation: Past,Present and Future

The history of kidney transplantation is thought to have originated at the early beginning of
the previous century with several attempts of Xenografting, and experimental works on
vascular sutures (Küss & Bourget, 1992)1. But it really started more than 60 years ago with
first attempts of deceased donor transplantation (DCD) and the first successful kidney
transplantation of homozygote twins in Boston (Toledo-Pereyra et al, 2008)2. Belgian
surgeons contributed to that field of medicine by performing in the early sixties the first ever
organ procurement on a brain dead heart beating donor (DBD) (June 1963) (Squifflet, 2003)3.
Later on, in the eighties, they published a first series of living unrelated donor (LURD)
transplantations, as well as ABO-Incompatible living donor (ABO-Inc LD) transplantations.
With the advent of Cyclosporine A, and later other calcineurin inhibitors such as
Tacrolimus, with the advent of more potent immunosuppressive drugs (IS), the gap
between the number of renal transplant candidates and the number of transplanted
recipients was and is continuously increasing in Belgium and most countries. It opened the
search for other sources of organs such as donors after cardiac death (DCD) defined with the
Maastricht conference and the extended criteria donors (ECD) compared to standard criteria
donors (SCD). In Belgium another source of DCD was identified after the promulgation in
2002 of a law on euthanasia. The Belgian example and all its historical measures could help
others to fight against organ shortage and its consequences, organ trafficking,
commercialization and tourism.