Blood and guts: a history of surgery. Part 3, Spare parts.

The third in a 5-part series in which Michael Mosley traces the evolution of surgery as it progressed, in his words, from butchery to brilliance. This part features transplant surgery. Mosley travels back in history to the 18th century in which the first transplants took place; the healthy teeth of the poor were stuck into the mouths of the bad-toothed rich. The Frenchman Alexis Carrel was the first surgeon to learn how to stitch arteries together after taking painstaking lessons from a seamstress. Carrel then went on to experiment with transplant surgery, mainly operating on animals although with no success. He hadn't understood the role of the immune system in rejecting transplanted tissue. Early footage of a kidney transplant is shown and Joseph Murray talks about his groundbreaking work in transplanting a healthy kidney from one identical twin to another. Murray realised that he also had to tackle the immune system so that it wouldn't reject the transplanted kidney - he used total body radiation so that the immune system would be irradiated however all patients he experimented on died from overwhelming infections. Roy Calne suggested using medicine to suppress the immune system rather than radiation and he experimented with cyclosporine mixed with olive oil to great success. After this heart transplants became more and more frequent. In 1997 the first hand transplant was performed on Clint Hallam - unfortunately not only did Hallam find it hard to adapt to the transplanted hand psychologically, he found the rejection medicines gave him unpleasant side effects but if he cut them down his new hand would begin to rot. Eventually the hand was completely rejected by his body and he had it surgically removed. Mosley meets Hallam and his new prosthetic arm. Surgeon Warren Breidenbach has performed several successful hand transplants; Mosley meets one of his patients.