Solid organ transplantation can yield cures for previously fatal diseases. The concept of transplantation is very old. According to legend, in the fourth century, Cosmas and Damian, twin brothers and physicians from Arabia, were credited with amputating the cancerous leg of the custodian of a Roman basilica and replacing it with the leg from a slain Ethiopian gladiator recently buried in the Church of St. Peter. As a result, the brothers were honored in artist Fra Angelica's painting (Figures 2.1) and recognized as the patron saints of transplantation.

In modern times, physicians envisioned replacing diseased organs with healthy ones, but before organs could be transplanted successfully, several technical medical problems had to be overcome (Table 2.1). The solutions included general anesthesia, first used in 1842 by a country doctor, Crawford Long, MD, in Jefferson, Georgia. After this procedure was publicly demonstrated in 1846 by a dentist, William Morton, at Massachusetts General Hospital, the technique of general anesthesia disseminated around the world in months. Next, studies by the chemist Louis Pasteur in Paris defined the role of bacteria in fermentation and putrefaction in wine making. These findings convinced the great surgeon Joseph Lister, of Glasgow, that similar germs in the air were responsible for surgical infections, an idea that led him to develop antiseptic surgery in the 1860s.