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Wednesday, December 29, 2010

The Beginning of Organ Transplants

December 29, 2010:
Today’s Boston Globe contains a long obituary following the death Monday of the first human kidney transplant donor. It recalls the story of a remarkable event 56 years ago that ushered in the age of human organ transplantation.

But the Globe’s obituary of 79-year-old Ronald Lee Herrick, and related stories in hundreds of other newspapers (and NPR), fail to recall an important element of that achievement.

Here is what today’s reports tell us.

Dec 23, 1954: Identical twins are operated upon at Peter Bent Brigham Hospital in Boston. A donor kidney is harvested from 23-year-old Ronald Herrick and transplanted by surgeon Dr. Joseph E. Murray into Herrick’s dying brother.
Richard, the recipient of the life-saving organ, survives, marries his nurse and later has two children. He dies from cardiac disease eight years later. Dr. Murray later receives the Nobel Prize for his monumental achievements in organ transplantation. Ronald's brother lives to age 79.

But the story didn’t start in 1954 with the Herrick twins. Years earlier, Dr. Murray had concluded that dog experiments had to precede any thought of kidney transplants in people. As Murray wrote in his 2001 autobiography, Surgery of the Soul, “The problem had to be approached systematically and—as is often the case in medical science—requires experiments involving animal models first. We started by transplanting kidneys between dogs.”

His dog experiments involved tissue rejection trials, finding the ideal place for the new kidney in the recipient’s body, developing techniques for reattachment, and so on. These were neither simple nor quick experiments, and they went on for a long time and involved operating on many, many dogs.

Again, Dr. Murray, from his book: “By the summer of 1954, as a result of these experiments, several animals had survived for years with [kidney transplants]. These animal behaved normally in every way. ... These animal experiments were critical to the ultimate success of our renal transplant program because I knew with certainty that a transplanted kidney ... could function normally indefinitely. That was a revelation and most encouraging.” A few months later, “the Herrick twins entered my life.”

Between approximately 1900 and 1970, dogs were the mainstay for physicians and surgeons involved in animal experimentation and surgical training. We owe a tremendous debt to the hundreds of thousands of dogs sacrificed to facilitate medical advances like the achievement being remembered today.

Readers may also be interested in a related blog, "A Holiday Book for your Favorite Veterinarian", posted December 8, 2010 on this site.

Dr. Smith invites comments at