SLICE OF HISTORY
Dr. Richard Lawler, a surgeon at the Little Company of Mary Hospital in Chicago, had done a few experimental organ transplants with dogs, but now he has going to try the procedure on a human. The patient is Ruth Tucker, a 49-year-old woman whose mother and sister had already died of polycystic kidneys, and the disease has caused her own kidneys to almost stop functioning. This is before dialysis is available and it’s clear that Tucker will die soon if something isn’t done.
Shortly after another 49-year woman with cirrhosis of the liver dies in an adjacent operating room, doctors remove one of her kidneys and bring it into Lawler. It takes him only an hour and a half to replace Tucker’s left kidney. At least 40 other doctors watch the surgery, with those in the back row standing on tables to get a better view. One of them has to take over filming the procedure when the photographer faints.
What made the operation that much more remarkable was that it was attempted before immunosuppressant drugs that counter the body’s rejection of an organ–now standard treatment for transplants patients–were available, and before the development of tissue typing that ensures a good match between donor and recipient. Tucker had waited in the hospital five weeks for a donor, but the selection was based more on finding someone of the same gender and close to her age and size.
But the transplant took, at least initially, and a month later Tucker went home. Within a year, however, her kidneys were producing less and less urine, and when Dr. Lawler opened her back up, he could see that the new kidney had shrunken in size, suggesting that her body’s immune system was rejecting it. Nonetheless, the transplanted kidney had worked well enough for her to recover some of her own natural kidney function, and she lived until 1955. She died of coronary artery disease, which doctors believed was unrelated to her transplant.
For several years, other doctors in the U.S. and in France attempted kidney transplant surgeries, but none of the patients survived. The next successful transplant wasn’t done until 1954, when doctors at Peter Bent Brigham Hospital in Boston removed a kidney from Ronald Herrick and transplanted it into his identical twin, Richard.
But that was a situation in which rejection was unlikely. It actually wasn’t until the early 1960s, when both tissue typing and immune suppressant drugs had been refined, that organ transplants became considerably less risky. Between 1954 and 1973, about 10,000 kidney transplants were performed.
Transplant surgery really took off in the 1980s after a much more effective immunosuppressant, called cyclosporine, was developed. In 1986 alone, nearly 9,000 kidney transplants were performed in the United States, with a greater than 85 percent survival rate for the first year. Today, almost 70,000 kidney transplants are performed around the world every year.
The irony is that Dr. Lawler, the surgeon who performed the first one, never did it again. Although he was besieged with letters from doctors wanting to learn from him and from patients seeking his services following the transplant surgery on Ruth Tucker, he demurred. He had no interest in becoming a transplant surgeon. As he told an interviewer, “I just wanted to get it started.”