The Birth of Transplantation Immunology: The Billingham-Medawar Experiments at Birmingham University and University College London

The 1951 paper by Rupert Billingham and Peter Medawar in J. Exp. Biol. was pivotal in the development of transplantation immunology, particularly in skin grafting. It introduced fundamental concepts such as actively acquired tolerance and the second set phenomenon, which demonstrated immunologic memory. Their experiments showed that neonatal transplantation could lead to allograft acceptance, highlighting the role of thymic education in T cell development. The work also revealed that corticosteroids could delay graft rejection, paving the way for overcoming transplantation barriers. Although focused on skin, the principles extended to other organ transplants, influencing the field significantly and contributing to Medawar's Nobel Prize-winning research. The paper's impact persists, underpinning much of modern transplantation biology.