The history of living donor advocacy in living donor transplantation

The history of living donor advocacy importantly highlights the maturation of the field of transplantation. The first successful kidney transplant performed on identical twins in 1954 confirmed the feasibility and efficacy of the surgical procedure. The process that led up to the operation itself set the groundwork for the concepts that would evolve into living donor advocacy. In this chapter, we hope to provide a historical overview of the dynamics that formed the concept of advocacy for living donors including kidney as well as extrarenal donation. As the language of living donor advocacy is now coded into Centers for Medicare and Medicaid Services (CMS) regulations, it is extremely helpful to examine the historical origins of the concept of advocacy in relationship to the development of living donor transplantation.