The ancient dream of successful organ transplantation was finally realized 50 yr ago, on December 23, 1954, at the Peter Bent Brigham Hospital in Boston. Over the subsequent half century, the separate disciplines of clinical transplantation and transplant immunology have made remarkable progress. The story of the convergent evolution of these two fields represents one of modern medicine's most important advances. This path of discovery has uncovered both the practical and the fantastic, and

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... g the way, it has been marked by the awarding of more Nobel Prizes than any other field of medicine. The movement of functional organs from one individual to another and the clinical manipulation of the immune system necessary to make this movement successful have gone from being a tour de force to part of everyday clinical practice in just 50 yr. Perhaps most striking, however, is the enduring effect of these advances on the way we think and dream about medicine itself. The purpose of this review is to enable the reader to share the hope and excitement present in the disciplines of immunology and transplantation, which together stand on the brink of what we believe will be a revolutionary second half century. We will focus in equal measure on the historical context in which the first successful kidney transplant operation occurred and the current milieu of transplantation, which itself is characterized by both rapid discovery and continued controversy. Finally, predictions about both the probable and the possible landmarks for the next 50 yr of transplantation will be proposed.