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Biographical entry Murray, Joseph Edward (1919 - 2012)

MD Harvard; Hon FRCS 1986.

Born
1 April 1919
Milford, Massachusetts, USA
Died
26 November 2012
Boston, Massachusetts, USA
Occupation
Plastic surgeon and Transplant surgeon

Details

Joseph Murray had an illustrious career as a plastic and reconstructive surgeon, but his unique achievement was to perform the first successful kidney transplant, on identical twins, in 1954, for which he was awarded a Nobel prize in physiology or medicine in 1990.

He was born in Milford, Massachusetts, the son of William A Murray and Mary Murray née DePasquale. He was educated at Milford High School and the College of Holy Cross, earning a degree in the humanities in 1940. He then attended Harvard Medical School and, after graduating, began his internship at the Peter Bent Brigham Hospital.

He then joined the Army and was sent to Valley Forge General Hospital in Pennsylvania, where he worked with James Barrett Brown, the chief of plastic surgery. Here he developed his interest in plastic surgery, in particular the possibilities of skin transplantation.

Murray was finally discharged from the Army in November 1947, completed his general surgical training, and joined the surgical staff at the Peter Bent Brigham Hospital. He then went to New York to train in plastic surgery at New York and Memorial hospitals, returning to Brigham in 1951.

At Boston there was a confluence of interest in the possibility of organ transplantation. The team were fortunate in having outstandingly qualified experts in the relevant disciplines. Francis D Moore's surgical clinical academic department was pre-eminent in experimental surgery and George Widmer Thorn's department of medicine was also of premier status, where the research was spearheaded by John Merrill. The surgical team had demonstrated their confidence in performing autologous kidney transplants in the dog and, when a patient in renal failure was referred to Merrill, the doctor's letter pointed out that the patient was one of identical twins. By this time Murray had taken over the kidney transplant research laboratory, which had previously flourished under David Hume, who had moved to a surgical chair in Richmond, Virginia.

Murray's technical skills gave him and the whole team confidence to proceed with the clinical transplant, which was a spectacular success. It showed that surgeons could do the operation and the kidney could withstand the trauma of the procedure. Sadly, when transplants were performed between individuals who were not twins the results were disastrous and the attempts to prevent rejection using irradiation were toxic and ineffective. The introduction and development of chemical immunosuppression using 6-mercaptopurine and its derivative, azathioprine, enabled tolerable clinical results to be obtained between non-twin transplants. Improvements followed the addition of corticosteroids to the regimen, and the whole field changed dramatically with the introduction of cyclosporine, which altered the perception of organ grafting from a risky experiment to a much sought after therapy.

Murray established a clinical programme of kidney transplantation at the Peter Bent Brigham and then returned to his first love, reconstructive surgery, but he continued to take an interest in organ transplantation for the rest of his life.

Murray was a meticulous surgeon with his techniques honed in plastic surgery. He was devotedly religious and wrestled with the ethical dilemmas of transplantation in order to clarify the issues and proceed in the best interests of the patient. He was a kind and very generous man, whose philosophy centred on the paramount importance of the patient's needs. His traditional approach to medical care was a wonderful example to all who had the privilege to work with him. He was awarded the Nobel prize in 1990 for demonstrating that the surgery of organ transplantation was possible, which gave heart to everyone interested in the immunology of rejection.

Organ transplantation has been an extraordinary success story, with more than a million recipients of organ grafts, some still functioning 40 years after transplantation. This success followed Murray's pioneering efforts, which led the field from an uncertain wish, to one of the most important new life-saving therapies.

Murray married Virginia 'Bobby' Link in June 1945 and they had a large, happy family, with a huge circle of friends and admirers, especially the surgical fellows who had the privilege to learn from him. He died on 26 November 2012, in Boston, aged 93.

Sir Roy Calne

Sources used to compile this entry: [The Guardian 28 November 2012; The Nobel Prize: Joseph E Murray - Biographical www.nobelprize.org/nobel_prizes/medicine/laureates/.../murray-bio.html‎ - accessed 11 December 2013].

The Royal College of Surgeons of England