The Subject: The “Invention” of Organ Transplantation

A therapy “which aims at replacing the organ that has lost its function in the organism” is nothing to be made light of, the surgeon Otto Lanz warned his colleagues in 1894. Today, no one would doubt the seriousness of a surgeon who treats a disease by replacing an organ. To us it seems self-evident that certain internal diseases result from the failure of a particular organ, and it makes sense to treat them by replacing that organ. This is why it may come as a surprise that before the 1880s no one had even dreamed of treating internal diseases by transplanting organs. Such an approach did not exist. Organ transplantation, together with the corresponding assumptions about the nature of the body and disease, did not arise before the period from 1880 to 1930. There was no such thing as an ancient dream of mankind about organ transplantation.

At this point a definition is called for: this study deals with organ transplantation as it is carried out today for the kidneys, pancreas, heart, or liver. In order to cure diseases such as renal insufficiency or diabetes, an organ or organ tissue is put into the body, where it continues to live and function. Organ transplantation thus differs fundamentally from the transplantations carried out in plastic surgery, where the surgeon replaces damaged parts of the body’s surface. The latter process has been performed for centuries and falls within the traditional purview of surgery. From the perspective of today’s organ transplantation, the crucial innovation was to apply this already existing approach to the interior of the body and to the treatment of “internal” diseases. Contemporary writers were already aware that “the transplantation of organs and fragments of organs in order to replace the specific function of organs that are degenerated or do not work for other reasons” constituted a particular and novel field of activity.

Until about 1914 the new therapeutic concept boomed. “We are today in an era of transplantation,” a surgeon commented in 1918. At the time, however, the rise of organ transplantation was already turning into a decline, and by 1930 the subject had been almost completely abandoned.