Between 1900 and 1930, in this country and abroad, workers like Carrel and Ullmann were performing this type of experiment. Kidneys were most often used because of their simple vascular supply. The ureters functioned within minutes and gave an index to work with. Although Carrel recognized the transferred kidneys functioned normally, put out urine and maintained life, he was unaware what was causing their loss. The concept of rejection was not yet understood.
The realization of rejection taking place was thought to be due to a process quite distinct from infarction (ie., loss of arterial blood supply) infection, or inflammation. Initially, the term rejection indicated a process by which the host was not accepting of the new organ. It was not long before it was understood that there might be some relationship involving the immunologic process by which an organism combats invading bacterial infection.
In the mid 1920's Emile Holman, a surgeon of the Hopkins, Harvard, and Stanford, carried out an experiment grafting skin from a mother onto her badly burned child. The child not only rejected the mothers skin, he developed a severe necrotizing inflammation of his own skin. This suggested shared antigens between the child and his mother and the development of an autoimmune disease as the cause of the necrotic dermatitis. Although the implications were evident, attempts to study them further were not possible until early in 1951 when the group of David Hume, George Thorn, and Gustave Dammin at the Peter Bent Brigham
Hospital in Boston got together to experiment with the grafting process. One important aspect of the groups experience was their collaborative scientific work involving medicine, surgery, pathology, radiology and immunology. It was the forecast of the group collaboration which marked the efforts of many institutions during the coming decades.