Abstract.The origins and development of the renal transplant program at the Peter Bent Brigham Hospital (now the Brigham and Women's Hospital) from the late 1940s to the present are reviewed. The program was initiated as a effort to understand hypertension as a cause of renal failure. The initial transplants were unmodified allogeneic grafts placed in the thigh, followed by extensive laboratory experiments on dogs. This research culminated with the first successful human transplant of a kidney between identical twins in 1954. In 1959 the first successful fraternal allogeneic graft was accomplished as part of a protocol utilizing total body irradiation and bone marrow replacement. Finally, with the development of immunosuppressive drugs, we were able to transplant a cadaveric kidney successfully in 1962. This was a major impetus in the study of organ transplantation worldwide, which currently involves kidneys, liver, heart, pancreas, heart/lung, and bone marrow.