ABSTRACT
In 1965, the three-hour written paper for Part II of the examination for Membership of the Royal College of Physicians consisted of essay questions (plus a French translation!), one of which was: ‘Discuss the ethics of renal transplantation.’ That this question was asked reflected the fact that this method of treatment had begun only in the previous decade and was still in its infancy. The problem was not a technical surgical one since the transplant procedure itself is reasonably straightforward. The main bar to success was the problem of immunological rejection of the transplant kidney by the recipient. The major breakthrough was the introduction of the immunosuppressive drug, azathioprine, which was combined with corticosteroid treatment to suppress the rejection process. A useful contribution was also made by the practice of immunological matching between donor and recipient (tissue-typing).
