الثلاثاء، 27 نوفمبر 2012

Dr. Joseph E. Murray, Transplant Doctor and Nobel Winner, Dies at 93

Dr. Joseph E. Murray, who opened a new era of medicine with the first successful human organ transplant, died on Monday. He was 93 and lived in Wellesley and Edgartown, Mass.

He died in Boston at Brigham and Women’s Hospital, where he performed his first transplant, said Tom Langford, a hospital spokesman. The cause was complications from a stroke he suffered on Thursday, Mr. Langford said. Dr. Murray’s groundbreaking surgical feat came in 1954, when he removed a healthy kidney from a 23-year-old man and implanted it in his ailing identical twin. Dr. Murray went on to pioneer techniques that over the years changed the lives of tens of thousands of patients who received new kidneys, hearts, lungs, livers or other organs after their own had failed.

In 1990, he was awarded the Nobel Prize in Physiology or Medicine.

As director of the Surgical Research Laboratory at Harvard Medical School and at Peter Bent Brigham Hospital in Boston, which became Brigham and Women’s, Dr. Murray was a leader in the study of transplant techniques, the mechanisms of organ rejection and the use of drugs to thwart it.

Among other procedures, he performed kidney transplants involving more than two dozen pairs of identical twins. He recorded the first successful transplant to a nonidentical recipient, in 1959, and the first using a cadaver kidney, in 1962. And he trained doctors who became leaders in transplantation around the world.

Though Dr. Murray devoted most of his career to reconstructive plastic surgery, he was most famous as a transplant surgeon, especially after receiving the Nobel. He shared the $ 703,000 prize with Dr. E. Donnall Thomas, a pioneer in bone marrow transplantation. The award was unusual in that the Nobel Committee typically honors researchers rather than clinical practitioners.

Joseph Edward Murray was born April 1, 1919, in Milford, Mass., the son of William Murray, a judge, and Mary DePasquale Murray, a schoolteacher. He attended the College of the Holy Cross and Harvard Medical School, from which he graduated in 1943. After an abbreviated internship at Brigham, he entered the Army Medical Corps in 1944.

It was his experience as an Army doctor, especially using cadaver skin to treat burned soldiers, that led him to both transplantation and facial reconstruction, Dr. Murray said in an interview in 2001. Though the transplanted skin would survive for only 8 or 10 days before it would “begin to melt around the edges,” Dr. Murray recalled, the experience taught him that tissue from one person might survive for a time in another and that it might be possible to use “tissue from a dead person to save a human life.”

So when he returned to civilian life and began practicing as a plastic and general surgeon at Brigham, he joined colleagues in investigating the possibilities of organ transplants. At the time, he recalled, organ transplantation was considered such a wild dream that a medical school mentor advised him to abandon the idea as a clinical dead end. At Brigham, the work “was considered a fringe project,” he wrote in his autobiography, “Surgery of the Soul,” published in 2001 by History Publications/USA.

But he and his colleagues began testing surgical techniques with dogs, removing and reimplanting kidneys. Then, in October 1954, Richard Herrick, a Massachusetts man dying of chronic nephritis, a kidney disease, was admitted to the hospital, and his doctors referred him to Dr. Murray as a possible transplant recipient. The man’s identical twin, Ronald, was willing to give him a kidney. Would Dr. Murray perform the surgery?

It was a daunting prospect. Dr. Murray worried about “taking a normal person and doing a major operation not for his benefit but for another person’s,” he said in the 2001 interview.

“We were criticized for playing God,” he said.

After consulting with clergy members from a range of denominations, and comparing the Herricks’ fingerprints to be sure they were identical and not merely fraternal twins, Dr. Murray and his colleagues decided to go ahead. They first practiced their surgical techniques on a cadaver. The donor kidney “was the only kidney in the universe that was compatible,” Dr. Murray said, “and I did not want to goof it up for technical reasons.”

The surgery took place on Dec. 23, 1954. As Dr. Murray wrote later, “There was a collective hush in the operating room” as blood began to flow into the implanted kidney and urine began to flow out of it.

Richard Herrick, who later married one of his nurses, survived until 1962, when he died of a recurrence of his original disease.

Two other patients were important to Dr. Murray’s medical career, both professionally and personally.

Michael Schwirtz contributed reporting.

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