The Graft

"The Graft is a warmly written account of the kidney transplant performed in 1950 at a small Catholic hospital (Little Company of Mary) in Chicago by a team of skilled doctors. The case, subsequently reported in JAMA, involved a patient with polycystic kidney disease who experienced early graft function followed by rejection within months but maintained adequate native renal function to live another five years. The lead surgeon, Richard Lawler, did not perform additional transplants, but this index case prompted both support and criticism from the medical and ethical communities, perhaps spurring academic medical centers to develop an immunological basis for transplantation. The history of this case is explained in medical laymen's language and provides more thorough documentation of the details than previously published. The story of that particular transplant and the people and institution involved is followed by discussion of the medical and ethical considerations of transplantation, and a sample of transplant surgeon stories, and a summary of some of the historical policy developments in transplantation that followed. It is of particular interest that a Catholic hospital in Chicago in 1950, run by nuns, provided the institutional support for a highly innovative surgical procedure for the time. The narrative is engaging and personal, written by a relative of the surgeon Lawler." - Stuart J. Knechtle, M.D., William R. Kenan, Jr. Professor of Surgery, Executive Director, Duke Transplant Center