Clinical kidney transplantation: a 50th anniversary review of the first reported series.

BACKGROUND Histories of kidney transplantation rarely mention a series reported by Gordon Murray of Toronto and published by the American Journal of Surgery 50 years ago. METHODS The papers and biographies of Gordon Murray were reviewed in the context of knowledge at that time about renal failure management to determine their contribution to transplantation research and to current practice. RESULTS Murray proceeded from a unique leadership position in vascular surgery, anticoagulation therapy, and dialysis to undertake a rational series of animal experiments and human trials of kidney transplantation that led him to the practices of graft irrigation, cold storage, pelvic graft placement, renal-to-iliac vascular anastomoses, and ureterovesical anastomosis that continue to be used today. His animal studies included the first attempts to use immunosuppression and total body irradiation to prevent rejection. His observation that rejection may result in graft thrombosis and his attempts to prevent it with heparin anticipated current efforts to use newer agents for the same purpose in sensitized allotransplantation and xenotransplantation. CONCLUSIONS Modern renal transplantation is founded on many of the principles expounded by Gordon Murray 50 years ago.