Tuesday, November 27, 2012

Remembering a great pioneer

Dr. Joseph E. Murray, who performed the world's first successful kidney transplant and won a Nobel Prize for his pioneering work, has died at age 93. Since the first kidney transplants on identical twins, hundreds of thousands of transplants on a variety of organs have been performed worldwide. Murray shared the Nobel Prize in Physiology or Medicine in 1990 with Dr. E. Donnall Thomas, who won for his work in bone marrow transplants. "Kidney transplants seem so routine now," Murray told The New York Times after he won the Nobel. "But the first one was like Lindbergh's flight across the ocean." Murray's breakthroughs did not come without criticism, from ethicists and religious leaders. In the early 1950s, there had never been a successful human organ transplant. Murray and his associates at Boston's Peter Bent Brigham Hospital, developed new surgical techniques, gaining knowledge by successfully transplanting kidneys on dogs. In December 1954, they found the right patients, 23-year-old Richard Herrick, who had end-stage kidney failure, and his identical twin, Ronald Herrick.

Because of their identical genetic background, they did not face the biggest problem with transplant patients, the immune system's rejection of foreign tissue. After the operation, Richard had a functioning kidney transplanted from Ronald. Richard lived another eight years, marrying a nurse he met at the hospital and having two children. "Post-operatively the transplanted kidney functioned immediately with a dramatic improvement in the patient's renal and cardiopulmonary status," Murray said in his Nobel lecture. "This spectacular success was a clear demonstration that organ transplantation could be life-saving."

Murray performed more transplants on identical twins over the next few years and tried kidney transplants on other relatives, including fraternal twins, learning more about how to suppress the immune system's rejection of foreign tissue. One patient who received a kidney transplant from a fraternal twin in 1959, plus radiation and a bone marrow transplant to suppress his immune response, lived for 29 more years. Murray continued a long career in plastic surgery, his original specialty, and transplants. He was guided by his own deep religious convictions. "Work is a prayer," Murray told the Harvard University Gazette in 2001. "And I start off every morning dedicating it to our Creator."

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