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What you are about to read, is not a true d�j� vu. The world population has doubled since the end of World II, from a then three-billion-and-a-half, to the staggering figure of almost eight billion souls, since the middle of the 20th Century. It should scare us all the more, hearing that the world population tends to increase geometrically, (i.e., 1, 2, 4, 8. 16, 32 �). Human beings tend to fall into �ill-situations� in which organs like the heart, the kidney, the pancreas and the liver may fail to function, and the solution may be what has been termed, �organ-donation/transplantation�, taking out quasi the dead organ, and replacing it with a new one, �pilfered from another human being, dead or alive. But, even that seems not to be enough as a solution. In Israel, (one of the places on earth where medicine is best practiced), there seems to be a near-crisis in the demand for organ-transplants. Up to 10% of the population carries an ID-card for organ-donation. It says in quintessence, �My name is X or Y. In case of sudden death, my organs, as found useful, may be donated.� This �declaration� is said to reward these potential donors preference, when they themselves may need organs. Not so simple, eh? Just allow yourself to travel down this aisle, which may not be that new to you. It was 9:53 a.m., the place was Boston, Massachusetts, USA, and the year was 1954. The identical twin brother, Richard, had received one kidney from his brother Ronald. This, if it worked, would prevent Richard from dying of complications of end-stage renal (kidney) failure. The surgeons at the Peter-Bent-Brigham Hospital, working in two teams, had just put in the last stitch on the abdominal wall of the recipient. It went like this, one team of surgeons would harvest one healthy kidney from the individual called donor, (in this case, an identical twin brother). Another team would be �preparing a place�, in the lower abdomen of the one receiving the organ, and he is called in this set-up, and in medical terms, the recipient. Just to whet your intellectual appetite a little bit, the group of surgeons receiving the harvested kidney, will sew it to blood vessels (arteries and veins) in the pelvis, and then sew the organic tube, called the ureter, of the incoming kidney to its appropriate connection in the recipient. All should be well, when the blood vessels are hermetically connected (indeed, everything should be hermetically sealed) and the ureter is equally in place. The surgeons should feel rewarded when they see urine flow into the collecting bag. The urine should have normal color. That virtually is the end of the operation, whose preparation is known to outweigh in length and complexity, the procedure where the knife is held. At the appropriate time, days or weeks, all tubes should be removed, and the patient should feel pretty free, and good. What looks so simple is in reality, not like that at all. Our body is made by our creator to behave like a person who does not accept anything at all from others. His system recognises everything which is strange instantly, and rejects it outright. So, if someone needed a kidney, and he had close relatives, or a distant one, or even a complete stranger whose biology coincidentally �resembles� his or her own, then in theory, he/she could receive an organ. Most of the time, it is from a cadaver (dead donor). Organs that we have in duplicate could be treated that way with relative ease. We have two kidneys, two pairs of lungs, but just accept it, that we may not so readily expend one half of our lungs, like we could give one of our kidneys to someone else. Organs like the eyes, the testes, and the ovaries, would not render themselves to transplantations, the way the kidneys would. But in extreme cases, a lot of adjustments could be made. The unusually lucky situation in Boston fifty-four years ago was an exceptional case. The identical twins possess identical biology, and when their organs meet one another, as is the case in transplantations, they tolerate one another in perfect harmony. It could be regarded in an extended sense as �auto transplantation�. Auto transplantation is when organs are transplanted across �strange individuals�. The risk of rejection is virtually zero in auto transplantations. If that were not the case, the recipient would have had to receive medications called collectively, imuno-suppressive (immuno-depressive) drugs. One example of such drugs is Ciclosporin. They, in a way, deceive the cells of the recipient body not to recognise the incoming organ as �strange.� These drugs have potentially serious side-effects, and the care of the transplant-patient may throw an insurmountable challenge. Doctors have been toying with the ideal, and idea, that when organs go defunct, they should (could be) replaced by organs of other individuals, or species. Or an ideal situation, in which you may lose some skin in an accident and fresh skin from another area of you, is transplanted into you. Initially, attempts were made to transplant organs of sheep, swine, and cows into humans. It failed always. The concept of the immune-system playing a role, soon to be understood, did change everything. The milestones have been as follows: In 1954, the Boston breakthrough whereby a man lived for 26 years with a kidney from his identical twin-brother. In 1968, cardiac (heart) transplant by Dr. Christian Barnard and his team in Cape Town, South Africa, (Groote Schwuer-Hospital) was successful. Limbs have been transplanted in Australia, the USA, and Europe. In the Middle East and India, hundreds of organs, but especially kidneys, have been transplanted, and it has been a source of medical tourism. In Ghana, the last two years saw the first kidney transplant (as the report went, between British Surgeons and their Ghanaian counterparts). Three individuals received kidneys from living donors, and we are yet to receive follow-up reports. Since 1992, Germany alone has transplanted 2,092 kidneys, 512 human hearts, 502 livers, and 31 patients have received pancreatic transplants. It is obvious that the pancreas is the organ which seems least readily transplantable. Ironically, the incidence of diabetes mellitus being on the ascendancy should make the pancreas a target organ, because, when successful, the individual would be cured of diabetes mellitus, an incurable illness hitherto. How about stem-cells? These are special cells which possess �omnipotence�, and their ability as such, should give us the �working tool� to get any organ we want from the individual himself. It will obviate the risk of rejection completely. On November 16, 2008, doctors working from Spain, in corroboration with their Italian and German colleagues, showed the world it was possible to leave allo-transplantations (the bulk of all transplants worldwide) behind us. The research-teams have been able, using the stem-cell technique, to replace an irreparably damaged trachea in a woman afflicted with Tuberculosis. When universally applicable, all organs that have been subjected to transplantations in the past will be re-grown instead. Indeed, there must be a lot that we in medicine need to pick up when walking along everywhere, including the bushes. Lizards and snakes re-grow lost organs, but we don�t. The missing link need be sought. A holy requiem will need to be sung again for Christian Barnard and the old good fellows from Boston. Hurray!