JOSEPH EDWARD MURRAY
SURGEON
1-4-1919 - 26-11-2012
TOWARDS the end of 1954, 23-year-old Richard Herrick lay delirious and paranoid in a hospital bed in Massachusetts, trying to pull out his catheter. His symptoms were caused by chronic nephritis - the kidney inflammation that was killing him. His brother Ronald offered to do something extraordinary - donate a healthy kidney. This was before the days of immune-suppressing drugs, but Ronald appeared to be Richard's identical twin and his surgeon, Joseph Murray, believed transplantation ought to be possible in such cases.
Murray, a practising Catholic, consulted various religious leaders to discuss the ethical implications of transplant, and, to check that the brothers really were identical, called on the Boston police department, which took their fingerprints and confirmed that they were. Murray, disturbed by the idea of putting Ronald through major surgery from which he might not benefit, also experimentally transplanted skin patches between the brothers to confirm that they "took". The kidney operations went ahead on December 23, after Murray had rehearsed the procedure using corpses and dogs.
Another surgeon took the donor kidney from Ronald, which Murray connected to Richard's blood vessels and ureter. There was, he wrote later, a collective hush in the operating room, and then the kidney turned pink as blood entered it and "there were grins all round".
Richard was restored to health, married the recovery-room nurse, and lived a further eight years. Ronald lived until he was 79 and died of heart disease. The example set by Murray's operation, the first successful human organ transplant, has since saved the lives of countless people worldwide. In 1990 it earned Murray, who has died aged 93, the Nobel prize in physiology or medicine, shared with Donnall Thomas, a pioneer in the field of bone-marrow transplantation.
Murray was born in Milford, Massachusetts, and graduated from Harvard Medical School in Boston. He later joined the army and was assigned to Valley Forge, a military hospital in Pennsylvania and a leading plastic surgery centre. Among the many badly burned patients he treated there was a 22-year-old pilot, Charles Woods, who had been shot down over Burma and needed months of extensive surgery to reconstruct his face and hands. Murray and Woods became lifelong friends.
As a life-saving measure, the Valley Forge surgeons used transplanted skin as a temporary cover for burns victims, including Woods. Its slow rejection fascinated Murray: how could the body distinguish between another person's skin and its own? His boss, Colonel James Brown, postulated that when rejection was slow, it was because donor and recipient were genetically close.
Returning to civilian life at Boston's Peter Bent Brigham Hospital in 1947, Murray worked as a plastic and general surgeon, devoting his spare time to unpaid and unfunded transplant research on animals. In 1959 he pioneered the use of small doses of radiation to suppress the immune response that led to organ rejection, and later the use of azathioprine, the first immunosuppressive drug.
He transplanted kidneys between many identical-twin patients after the Herricks, and did the world's first successful transplant to a non-identical patient in 1959, when the early anti-rejection drugs had reached the market. Three years later he transplanted the first kidney from a deceased donor to a living recipient.
Murray resigned as chief of transplant surgery at Brigham in 1971 to concentrate on plastic surgery, and retired as Harvard professor of surgery in 1986. He gave away his Nobel prize money to Harvard medical school, the Brigham, and Boston children's hospital. Other honours included election to the US National Academy of Sciences and Institute of Medicine. After his retirement, he was in demand as a speaker, advising students to "keep their eye on helping the patients".
He is survived by his wife Bobby, along with their six children and 18 grandchildren.
Frequently Asked Questions about this Article…
Who was Joseph E. Murray and why is he important to medical history?
Joseph Edward Murray was a pioneering American surgeon (born 1919) who performed the world's first successful human organ transplant. A Harvard Medical School graduate and long-time Brigham surgeon, he advanced transplant surgery and immunosuppression techniques, won the 1990 Nobel Prize in Physiology or Medicine (shared with Donnall Thomas), and helped create the modern era of organ transplantation.
What was the first successful human organ transplant and what happened during that operation?
The first successful human organ transplant was a kidney transplant in December 1954 performed by Joseph Murray. Murray transplanted a healthy kidney from Ronald Herrick into his identical twin brother Richard, who was dying of chronic nephritis. Murray confirmed the twins were identical, rehearsed the procedure, and reported the dramatic moment when the transplanted kidney turned pink as blood flowed into it. Richard recovered, married his recovery-room nurse, and lived eight more years.
How did Murray and his team confirm donor–recipient compatibility before the first transplant?
Murray took several careful steps to confirm compatibility and address ethics: he consulted religious leaders about the ethics of transplant, had the Boston police fingerprint the brothers to confirm they were identical twins, and even transplanted small skin patches between them experimentally to make sure the grafts would 'take' before attempting the kidney operation.
What immunosuppression and transplant techniques did Murray pioneer?
Murray pioneered early immune-suppression approaches, including the experimental use of small doses of radiation in 1959 to suppress rejection and the clinical use of azathioprine, one of the first immunosuppressive drugs. He moved transplant practice from identical-twin procedures to successful transplants for non-identical patients once anti-rejection drugs became available, and performed the first kidney transplant from a deceased donor to a living recipient a few years later.
Why did Murray receive the Nobel Prize and what other honors did he earn?
Murray received the 1990 Nobel Prize in Physiology or Medicine (shared with Donnall Thomas) in recognition of his groundbreaking work in organ transplantation and its impact on saving lives. He was also elected to the U.S. National Academy of Sciences and the Institute of Medicine and held the Harvard professor of surgery title until his 1986 retirement.
How did Murray’s transplant work change modern healthcare and patient outcomes?
Murray’s successful kidney transplant and follow-up innovations in immunosuppression transformed organ transplantation from an experimental idea into a life-saving medical practice. His work opened the door to transplants between non-identical people and from deceased donors, innovations that have since saved countless lives worldwide and established transplantation as a core part of modern medicine.
What part of Murray’s early career helped shape his interest in transplantation?
Murray’s service at Valley Forge military hospital, a leading plastic surgery center, exposed him to badly burned patients treated with temporary skin transplants. Observing the variable rejection of skin grafts piqued his interest in how the body distinguishes foreign tissue from its own — a question that motivated his later transplant research at Peter Bent Brigham Hospital after returning to civilian life in 1947.
How did Murray handle his Nobel prize money and what was his message to future medical professionals?
Murray donated his Nobel prize money to Harvard Medical School, the Brigham hospital, and Boston Children's Hospital. In speeches and mentorship after retirement he emphasized patient-centered care, advising students to 'keep their eye on helping the patients,' a principle that underpinned his career and legacy.
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