Back in the mid-70s I spent several months as a student on the kidney ward in an Atlanta teaching hospital.
I remember at the time this hospital had only a limited number of artificial kidney dialysis machines
and were just beginning to transplant kidneys.
I asked some friends what they knew about transplant programs, and one said,
"You should always use starter fertilizer or a small dose of manure or organic compost,
and then water and sunlight does the rest."
The word transplant in South Dakota usually refers to plants not organs.
The dream of transplanting a functioning organ from one person into someone
with a failed kidney has been around for many years.
In 1902, an Austrian animal experiment showed transplanted kidneys failed after a few days
due to some unknown biochemical barrier and, for years afterward and despite multiple attempts
at transplanting kidneys and other organs, these efforts simply would not work.
The cause of rejection came in the 1940s when a London scientist began defining the body's protective immune system,
which fought invading infections and infestations, and which would also not allow an organ
with too many genetic differences to be transplanted from another body.
The first example where transplant helped the recipient occurred in 1950 when a cadaver kidney
was transplanted allowing a woman to live a while longer.
The second more successful transplant was in 1954.
The immune system problem was sidestepped when an identical twin gave his kidney
so the dying twin brother could live, and it worked for years.
Finally, in the '60s, we gained some ground, after learning about matching for blood transfusions
and, in a separate vein, about turning down the body's immune system using medications originally
used as chemotherapy for cancer.
Now, with even more advancements, we can successfully transplant hearts, livers, pancreases, lungs,
intestines, bone marrows, as well as kidneys.
It remains far from perfect, however, with more people in need or organs than are available,
with the suffering side effects of anti-rejection meds, and with the tremendous expense of such procedures.
Now the problem is when someone should NOT receive transplant.
The issue is not whether we can do it; it is whether we should do it.
When is a person too old, too sick, or too mentally incapacitated for transplant?
Advances in transplant science have brought wonderful improvements to the quality of many lives,
even saving costs over dialysis, but this all comes with also knowing when to let nature take its course.
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