Pioneering transplant surgeon

JOSEPH EDWARD MURRAY SURGEON 1-4-1919 - 26-11-2012



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.

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