Medical advances do not occur in isolation. They are usually the result of a combination of developments that come together to create a medical breakthrough. This is certainly the case for kidney transplantation. A combination of scientific understanding, technical expertise and drug therapy has made kidney transplantation one of the most successful types of transplant surgery, and provided the means for other more complicated transplant surgery.
As far as transplant surgery goes, kidneys are relatively simple. The first successful kidney transplant was performed in Boston in the United States in 1953. The procedure was carried out between identical twins, so rejection of the new kidney would be much less likely. However, the problem of rejection continued for another ten years until the drug azathioprine was developed. Prior to drug therapy, immunosuppressant therapy was by whole body radiation, which was highly risky for patients - many of them died within a few weeks of surgery. By 1963 azathioprine and regular high doses of steroids were administered to kidney transplant recipients and their survival rates improved. The use of ciclosporin from 1980 reduced these death rates even further.