Joseph Edward Murray (April 1, 1919 – November 26, 2012) was an American plastic surgeon who is known as the "father of transplantation" for major milestones in the field of transplantation, including performing the first successful human kidney transplant,[1][2] defining brain death, the organization of the first international conference on human kidney transplants and founding of the National Kidney Registry, the forerunner of the current United Network Of Organ Sharing (UNOS). By 2013, more than one million patients are estimated to have benefitted from organ transplantation around the world.[3]
Murray was born on April 1, 1919, in Milford, Massachusetts, to noted lawyer and local judge, William Murray and William A. and Mary (née DePasquale) Murray, a schoolteacher. He was of Irish and Italian descent. A star athlete at the Milford High School, he excelled in football, ice hockey, and baseball. After being influenced by his family doctor, Murray resolved to become a surgeon.[7]
Upon graduation, Murray attended the College of the Holy Cross with the intent to play baseball. However, his baseball practices and lab schedules conflicted, forcing him to give up the sport. He studied philosophy and English, earning a degree in the humanities at Holy Cross in 1940. Murray subsequently attended Harvard Medical School;[1] after graduating with his medical degree in 1943, Murray began his internship at the Peter Bent Brigham Hospital. During that time, he was inducted into the Medical Corps of the U.S. Army.[8]
Murray served in the plastic surgery unit from 1944 to 1947 at Valley Forge General Hospital in Pennsylvania. At Valley Forge General Hospital, he worked for Bradford Cannon, a prominent plastic surgeon, and developed a passion for plastic surgery. His unit cared for thousands of soldiers wounded on the battlefields of World War II, working to reconstruct their disfigured hands and faces. His interest in transplantation grew out of working with burn patients during his time in the Army. Murray and his colleagues observed that the burn victims rejected temporary skin grafts from unrelated donors much more slowly than had been expected, suggesting the potential for organ grafts, or transplants.[8] In particular Murray was impressed with the case of Charles Woods, a 22-year-old pilot who had sustained burns over 70% of his body, including his face and hands, which required covering the burned areas with cadaveric skin grafts. The donor grafts survived long enough for Woods’ own healthy skin to be harvested and used as autografts to cover the burned areas. Over the course of 24 operations, the surgical team was able to remodel his eyelids, nose, mouth and hands, with Woods surviving the operations and eventually becoming a successful businessman. Murray would later recall, “The questions raised and lessons learned in trying to help Charles would determine the course of the rest of my professional life.”. Murray's first exposure to the field of reconstructive surgery ignited his lifelong passion for correcting terrible physical deformities and spawned another interest, transplantation – for Murray had seen for the first time how the tissue of one person could be used to save the life of another.[9]
In 2001, Murray published his autobiography, Surgery Of The Soul: Reflections on a Curious Career, with stories about how surgery treats the souls of the patient and the surgeon, as well as the disease.[10]
Career
After his military service, Murray completed his general surgical residency, and joined the surgical staff of the Peter Bent Brigham Hospital. He then went to New York to train in plastic surgery at New York and Memorial Hospitals, returning to the Brigham as a member of the surgical staff in 1951. Many of his peers discounted his pursuit, believing that the problem of immune rejection was insurmountable,[9] as French surgeon Alexis Carrel (1873–1944), a 1912 Nobel Prize laureate, had concluded from his research that a “biological force” would forever prevent successful transplantation.[11]
Murray was a practicing Catholic and faith played a role in his professional as well as his personal life. During preparations for the first transplant surgery, Murray and his team consulted clergy of all denominations while weighing the ethical issues of the procedure.[12]
On December 23, 1954, Murray performed the world's first successful renal transplant between the identical Herrick twins at the Peter Bent Brigham Hospital (later Brigham and Women's Hospital), an operation that lasted five and a half hours. He was assisted by J. Hartwell Harrison and other noted physicians. In Operating Room 2 of the Peter Bent Brigham Hospital, Murray transplanted a healthy kidney donated by Ronald Herrick into his twin brother Richard, who was dying of chronic nephritis. Richard lived for eight more years following the operation, long enough to get married and have two children before succumbing to cardiac failure eight years later. His donor brother Ronald had no major complications and lived over 50 years after the surgery.[9]
Throughout the following years, Murray became an international leader in the study of transplantation biology, the use of immunosuppressive agents, and studies on the mechanisms of rejection, as well as the study of how to ensure the health and well-being of living donors, and unequivocal opposition to monetary payment for human organs.
In 1959, Murray went on to perform the world's first successful allograft, who received a kidney from his non-identical brother, after been treated with total body irradiation and continued to live for another 28 years.
in 1960, Murray had to get the approval of the Massachusetts Superior courtl before being able to transplant a kidney for a family who travelled from Red Deer, Alberta, Canada to see Dr. Murray from 12-year-old Lana Nightingale into her twin sister Johanna, who became the longest surviving kidney-transplant recipient with over 50 years, which is still the World Guinness Record for longest surviving kidney transplant patient.[13][14]
Dr. Murray teamed up with Nobel prize laureates Drs. George H. Hitchings and Gertrude B. Elion, both at Burroughs-Wellcome, who recognized the immunosuppressive capacities of 6–Mercaptopurin (6-MP) and synthesized the first immunosuppressive drugs. Together, they tailored the new drug Imuran (generic azathioprine) for use in transplants. The discovery of Imuran and other anti-rejection drugs, such as prednisone, allowed Murray to carry out transplants from unrelated donors. In 1962, Dr. Murray performed the first successful deceased donor (cadaveric) kidney transplant treated with Imuran, a derivate of 6-MP and steroids.[15] By 1965, the survival rates after receiving a kidney transplant from an unrelated donor exceeded 65%, and today the success rate for a kidney transplant from a living donor is 90–95% after one year and the transplanted kidney lasts 15 to 20 years on average.[16]
Dr. Murray worked on all the steps necessary to establish organ transplantation as the clinical treatment of choice for patients with irreversible organ failure. In 1962, Dr. Murray led the organization of the first international conference on human kidney transplants in 1962, followed by the founding of the National Kidney Registry, the forerunner of the current United Network Of Organ Sharing (UNOS). In 1967, he participated in defining brain death, when Robert Ebert, the Dean of the Harvard Medical School convened a group of physicians, ethicists, and legal scholars to examine the characteristics of a permanently nonfunctioning brain, and Dr Murray was a member of that committee, which included famed neurosurgeon William Sweet, neurologist Raymond Adams, and legal scholar William J. Curran. The work of this committee led to consistent criteria that could be applied prospectively to declare death and ultimately to the Uniform Determination of Death Act (UDDA) in 1981.[17]
As a Harvard Medical School faculty member, Murray trained physicians from around the world in transplantation and reconstructive surgery, frequently performing surgeries in developing countries. In his 20 years as director of the Surgical Research Laboratory at Harvard and as chief of transplant surgery from 1951 to 1971at the Peter Bent Brigham Hospital (which later became Brigham and Women's Hospital), he inspired others who became leaders in transplantation and biology throughout the world.
Notwithstanding his pioneering work in human transplantation, Murray's true passion was still reconstructive surgery. In choosing between the two, he decided to step down as chief of transplant surgery at Peter Bent Brigham Hospital in 1971 to focus on paediatric reconstructive surgery, becoming the chief of plastic surgery from 1972 to 1985 at the Boston Children's Hospital Medical Center in Boston, Massachusetts. He developed procedures for repairing birth defects and treating paediatric burn victims.
Murray retired as professor of Surgery Emeritus in 1986 from Harvard Medical School after recovering from a small stroke.[18]
Murray was elected as a member of the National Academy of Sciences and as a regent of the American College of Surgeons. He received the American Surgical Association's Medal for Distinguished Service to Surgery, the American Academy of Arts and Sciences' Francis Amory Prize, the American Association of Plastic Surgeons' Honorary Award and Clinician of the Year Award, and the National Kidney Foundation's Gift of Life Award.
Joseph Murray married his college life sweetheart Virginia (Bobby) née Link in June 1945, the two having first met at the Boston Symphony Orchestra, with whom he would have 6 children: 3 boys and 3 girls. At the time of his death, they had been married for 67 years and had 18 grandchildren and 9 great-grandchildren. Dr. Murray died on November 26, 2012, aged 93. He suffered a stroke at his suburban Boston home on Thanksgiving and died at Brigham and Women's Hospital, the very hospital where he had performed the first organ transplant operation.[22][23]
