A pioneer in organ transplantation discusses the amazing advances in the field One of the most spectacular medical advances of the twentieth century, organ transplantation has become a generally effective and routine treatment for patients with organ failure. In this riveting book, a well-known expert in the fields of clinical transplantation and transplantation research traces the evolution of organ transplantation from its initial stirrings in the imaginations of the ancients to its current status as accepted treatment for nearly 40,000 patients each year. Drawing often on his own firsthand experience, Dr. Nicholas L. Tilney tells the story of the advances in organ transplantation, discusses how societal forces have driven its development, and reveals how its current success is marred by commercialism and exploitation of the less fortunate. Dr. Tilney describes early transplantation attempts, the first successful kidney transplant in 1954 between identical twins, the scientific advances for suppressing the immune system, the introduction of the concept of host tolerance, the new research on donor matching, and the issue of donor brain death. He explores innovations in heart, lung, liver, and other abdominal transplants and reflects on the attempts to make transplants between species. Finally he explains how organ transplantation has become a vast business, creating ethical and logistical conflicts about organ donations.

In 1913, the Peter Bent Brigham Hospital in Boston admitted its first patient, Mary Agnes Turner, who suffered from varicose veins in her legs. The surgical treatment she received, under ether anesthesia, was the most advanced available at the time. At the same hospital fifty years later, Nicholas Tilney -- then a second- year resident -- assisted in the repair of a large aortic aneurysm. The cutting-edge diagnostic tools he used to evaluate the patient's condition would soon be eclipsed by yet more sophisticated apparatus, including minimally invasive approaches and state-of- the-art imaging technology, which Tilney would draw on in pioneering organ transplant surgery and becoming one of its most distinguished practitioners. In Invasion of the Body, Tilney tells the story of modern surgery and the revolutions that have transformed the field: anesthesia, prevention of infection, professional standards of competency, pharmaceutical advances, and the present turmoil in medical education and health care reform. Tilney uses as his stage the famous Boston teaching hospital where he completed his residency and went on to practice (now called Brigham and Women's). His cast of characters includes clinicians, support staff, trainees, patients, families, and various applied scientists who push the revolutions forward. While lauding the innovations that have brought surgeons' capabilities to heights undreamed of even a few decades ago, Tilney also previews a challenging future, as new capacities to prolong life and restore health run headlong into unsustainable costs. The authoritative voice he brings to the ancient tradition of surgical invasion will be welcomed by patients, practitioners, and policymakers alike.