December 23, 1954

Kidney transplantation

First successful long-term human kidney transplant

Before trusting that the brothers were truly identical, the team exchanged small patches of their skin — and checked their fingerprints.

Two operating rooms, side by side

At Peter Bent Brigham Hospital in Boston on 23 December 1954, two surgical teams worked in adjacent rooms to move a kidney from Ronald Herrick to his identical twin Richard, who was dying of chronic kidney disease. Both men were 23.

J. Hartwell Harrison led the donor operation and removed Ronald's kidney — surgery on a healthy person who would gain no physical benefit from it. Joseph E. Murray led the recipient team and implanted the organ in Richard.

Nephrologist John P. Merrill had used medication and temporary dialysis to stabilize Richard beforehand and managed his renal care around the operation.

Eighty-two minutes without blood

The donated kidney spent 82 minutes completely without blood flow. When circulation was restored it showed functional activity and began producing urine — the visible sign in the room that the transplant was working.

No immunosuppressive drugs were used. Reciprocal skin grafts, blood testing, physical comparison and fingerprint evidence had established that the brothers were monozygotic, letting the graft escape the rejection expected between genetically different people.

When the original report was published, the graft had been functioning for eleven months.

What it proved, and what it left unsolved

"First successful kidney transplant" needs the qualifier. Earlier human grafts had sometimes produced urine briefly; the Herrick case is conventionally recognized as the first successful long-term human organ transplant.

It did not solve rejection for ordinary donor-recipient pairs — the twins' genetic identity bypassed the problem rather than answering it. Modern tissue typing did not exist in 1954, which is why the team fell back on skin grafts.

Richard Herrick lived roughly eight more years; Murray shared the 1990 Nobel Prize in Physiology or Medicine with E. Donnall Thomas.

Sources

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What the sources leave uncertain

“First successful kidney transplant” requires qualification. Earlier human kidney grafts sometimes produced urine temporarily, but the Herrick operation is conventionally recognized as the first successful long-term human organ transplant.
The title names Harrison and Murray, but this was a multidisciplinary achievement. Harrison operated on the donor, Murray on the recipient, Merrill directed renal care, and numerous anesthesiology, nursing, laboratory, radiology, and pathology personnel participated.
The procedure did not solve rejection for ordinary donor-recipient pairs; the twins' genetic identity bypassed that problem.