Joseph Murray

views updated May 18 2018

Joseph Murray

Born in Milford, Massachusetts, Joseph Murray (born 1919) was a pioneer in the field of organ transplantation and, in 1954, was the first to successfully transplant a human kidney. For his efforts he was awarded the 1990 Nobel Prize in Physiology or Medicine.

On December 23, 1954, Richard Herrick became the first human to receive a successful organ transplant when he was given a kidney from his identical twin brother, Ronald, at Boston's Brigham and Women's Hospital. Joseph Murray was the thirty-five-yearold surgeon who presided over the five and one-half hour operation and took this momentous step in medical science. Today, over 50, 000 organ transplants are done yearly in the United States, with seventy-five percent of them involving kidneys, according to the Detroit Free Press. These remarkable procedures developed by Murray and the lives that they save would never have been possible without Murray's groundbreaking efforts. In acknowledgement of this contribution to humankind, Murray was honored with the Nobel Prize (shared with E. Donnall Thomas, a pioneer in bone marrow transplants).

Joseph Edward Murray was born April 1, 1919, in Milford, Massachusetts, to William Andrew and Mary (DePasquale) Murray. His father served as a district court judge and his mother was a teacher. Both parents instilled in Murray the values of a good education and service to others. With this in mind, Murray always knew that he wanted to be a doctor. In 1936, after graduating from high school, where he had been a baseball star, a good swimmer, tennis player, and an exceedingly good science student, he set out for the College of the Holy Cross in Worcester, Massachusetts. He received his B.A. in humanities in 1940 and went on to attend Harvard University Medical School, graduating in 1943.

After receiving his medical degree, Murray took a surgical internship at a Harvard-affiliated hospital, Peter Bent Brigham Hospital (now Brigham and Women's Hospital) in Boston. In 1944, he was given a commission in the U.S. Army Medical Corps and served at Valley Forge General Hospital in Pennsylvania as a plastic surgeon under James Barrett Brown and Bradford Cannon. In this post, he worked on soldiers coming back from the battlefields of World War II, including a childhood friend from his own hometown whose face had been damaged by a defective shell. He performed over 1, 800 surgeries during this period, specializing in the reconstruction of hands and eyes of burn victims. "We took care of thousands of casualties, many with severe burns, " he told Michael D. Lemonick of Time. "I was performing skin grafts and became interested in why skin wouldn't graft permanently."

At this time, the typical procedure for treating burned skin involved grafting-or transplanting-unburned skin from other parts of a patient's body to the burned areas. But often, the patient was so severely burned that there was not enough skin to be grafted. In these cases the doctors would practice allografting, in which they used the skin of another person to cover the burned areas. In the 1940s, allografting was not a permanent solution because the patient's body would soon reject the foreign skin and it would fall off. Murray's mentor, Brown, had studied this problem in the 1930s and discovered that the only allografts that were successful were those between identical twins. At that time, the common theory of organ rejection, proposed by French surgeon Alexis Carrel, suggested that the body attacked foreign tissue or skin as if it were fighting off, or resisting, a disease.

As Murray was becoming more deeply involved in issues of organ transplantation, he was also starting his own family. In 1945 Murray married singer and pianist Virginia Link. They would eventually have six children. Two years after his marriage, Murray left military life and returned to Boston's Brigham and Women's Hospital. He became a member of the hospital's team of doctors studying end-stage renal (kidney) disease. One of the processes this team was studying was the practice of kidney transplantation. Murray had originally hoped to specialize in plastic surgery, but this was a very young discipline in the late 1940s, and he was encouraged by others to go into general surgery while keeping plastic surgery as a sideline specialty. He soon won a reputation among his colleagues for his neck and head surgical reconstructions on cancer patients as well as gaining recognition for the field of plastic surgery. His assignment within the Brigham group, however, was to find a competent surgical procedure for kidney transplants. After working on dogs for many years, he gradually developed a technique that is still used today of placing the transplanted organ in the lower abdomen. Before then, no one knew how long a kidney would be able to survive outside the body or the complicated surgical techniques of attaching a donated kidney to the recipient's blood vessels and extremely precise urinary system.

Murray and the Brigham team had their first chance at a successful kidney transplant in 1954. A patient who was suffering with kidney failure had an identical twin brother who was willing to donate one of his kidneys. Even after fifteen previous failures in which the transplanted organ was rejected within hours or days, Murray felt that the transplant was the only way to save the man's life. With this in mind, Murray told the Los Angeles Times, "we were struck with the moral problem of removing a healthy organ from a healthy person." The doctors in the team consulted the clergy and were even granted a special decree from the Massachusetts Supreme Court that allowed the operation to proceed. The operation was a success and the patient lived eight additional years before dying from congestive heart failure brought on by the same kidney disease that had necessitated the transplant. "Kidney transplants seem so routine now, " Murray told Gina Kolata in the New York Times. "But the first one was like Lindbergh's flight across the ocean."

In the late 1950s, Murray and his team continued to perform transplants, but at a slow rate. Between 1954 and the early 1960s only a dozen transplants were performed. Murray shifted the focus of his research to study the body's immune system, which would attack a foreign transplanted organ as an invader. He eventually developed drugs and techniques to reduce the body's own fight against transplanted organs and thus curb the rejection of those organs. He began studying transplants in fraternal twins, often using low doses of X-rays to help suppress the patient's immune system. It was also during this period that Murray had one of his greatest successes in transplantation with the longest-living kidney transplant recipient, Edith Helm. Helm received a kidney from her sister in May of 1956 and continued to correspond with Murray into the 1990s.

During the 1950s, significant advances were being made in pharmaceutical research, especially in the area of manipulating the immune system. In 1951 two scientists out of the Burroughs Wellcome Research Laboratories developed a drug called 6-MP (6-mercaptopurine). Initially used to treat leukemia, a form of cancer, 6-MP was found to inhibit the immune system from reacting to a foreign substance in the body. Later tests by British researcher Roy Calne and Boston hematologists Robert Schwartz and William Dameshek of kidney transplants in dogs using 6-MP found that the drug reduces the body's rejection of transplanted organs. The two scientists from Burroughs, Gertrude B. Elion and George H. Hitchings Jr., were awarded the Nobel Prize in 1988 for their work.

In 1961, Murray and other researchers at Brigham (including Elion, Hitchings and Calne, who had moved to Boston to collaborate with Murray) developed Imuran (azathioprine), an immunosuppressive drug still in use today. The next year, they used the drug successfully for the first time in a kidney transplant from an unrelated donor. This was the first time an operation of this type had worked. By 1965, the survival rates after receiving a kidney transplant from an unrelated donor were exceeding sixty-five percent. Later drugs, including cyclosporine and FK-506, pushed the survival rate even farther using the basic principles developed by Murray and his team at Brigham. As Murray's successes rapidly became known worldwide, other physicians began experimenting with organ transplantation.

Beginning with his days working on burned soldiers at Valley Forge General Hospital, Murray continued to develop his interest and skills in plastic surgery. After working primarily in the field of organ transplantation for years, he switched back to plastic surgery. One of his most notable efforts in this field involved children, specifically devising new ways to correct inborn facial defects. From 1951 to 1986 he worked in the plastic surgery division of Brigham and Women's Hospital, retiring as chief of plastic surgery. During that same period, from 1972 to 1985, he also served as a plastic surgeon at Children's Hospital Medical Center in Boston. Murray retired from active surgery at Brigham in 1986 but remained on staff as chief emeritus of plastic surgery at Brigham. He has also been on the staff at Harvard University since 1970 as a professor of surgery.

In 1990, Murray shared the Nobel Prize for Physiology or Medicine with bone marrow transplant pioneer and friend E. Donnall Thomas. They were credited with making discoveries "crucial for those tens of thousands of severely ill patients who either can be cured or given a decent life when other treatment methods are without success, " the Nobel committee's citation read, as quoted in Time. Murray donated his half of the award, approximately $700, 000, to Harvard University Medical School.