Tuesday, November 27, 2012

Joseph Murray's legacy - UAB and beyond

Dr. Joseph E. Murray, the surgeon who performed the first successful organ transplant in 1954 in Boston and whose groundbreaking work has changed the lives of thousands of people who have received new hearts, lungs, livers, kidneys and other organs in the past 58 years died Monday. He was 93.

His first successful kidney transplants were with identical twins. He went on to perform the first successful transplant with a nonidentical donor and recipient in 1959, and did the first successful cadaver kidney transplant in 1962.

“I think we take for granted what an  incredible procedure kidney transplantation is,” says Roslyn Mannon, M.D., director of research at the UAB Comprehensive Transplant Institute, professor of medicine and surgery, and president of the American Society of Transplantation. “When I reflect on medicine during that time, this was a cutting edge, ‘out there’ procedure, and I suspect some of Dr. Murray’s colleagues thought this would never be successful or even ludicrous. But time, diligence, and effort and the advancement of immunosuppression have led to the transplant procedure as almost commonplace.”

Murray, who was awarded the Nobel Prize in Physiology and Medicine in 1990, also trained doctors who became leaders in transplantation around the world including UAB’s first transplant surgeon, says Robert Gaston, M.D., medical director of the UAB Kidney and Pancreas Transplant Program, co-director of the UAB Comprehensive Transplant Institute, and immediate past president of the American Society of Transplantation.

“Dr. Arnold G. Diethelm, who performed the first successful kidney transplant and founded the program at UAB in 1968, was Murray's fellow in Boston in the early 60’s,” Gaston says. “He was in many ways the inspiration for what became the outstanding transplant program at UAB. And, it was Murray's work with Dr. John Merrill, a pioneer in transplant nephrology, that set the standard of close collaboration between surgery and medicine that has, in many ways, distinguished the kidney program at UAB from other notable programs around the country.  It is this link that also provided the inspiration for creation of the Comprehensive Transplant Institute at UAB. ”

Murray’s work as director of the Surgical Research Laboratory at Harvard Medical School on what causes organ rejection and early immunosuppression drugs laid the cornerstone of successful organ transplantation, Mannon says.

“Today, in the US, we perform thousands of kidney transplants a year, no longer in highly matched genetically related donors, but now deceased donors, extended criteria deceased donors, and living unrelated donors, sometimes via paired donation from incompatible donor and recipients willing to make their gift to a stranger,” Mannon says. “Immunosuppression too has come a long way—it would not have, however, if not for Joseph Murray’s pioneering spirit that had the dream and foresight into the possibilities.”

Gaston says in remembering what he did for organ transplantation, it is important to remember the person Dr. Joseph Murray was.

 “Murray was truly a giant and always on the cutting edge,” Gaston says. “But he also was always patient focused, always collaborative, and always humble. Joe Murray visited UAB shortly after the Nobel ceremony, and then again as the first Diethelm lecturer a few years later. It was my privilege to dine with him on both occasions, both memorable occurrences for me.” 

This coming weekend, Mannon is speaking at Houston’s Methodist Hospital’s George P. Noon Conference on the Management of Organ Failure celebrating the 50th Anniversary of organ transplantation at Methodist. The conference, she says, is a great example of how the field has evolved when you look at the distinguished speakers in liver, pancreas, heart, lung transplantation who will be there.  

“Did Dr. Murray have any notion at the time of what his one spark would light?” she asks.

No comments: