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Biographical entry Barnes, Anthony David (1934 - 2016)

BSc Birmingham 1958; MB ChB 1958; FRCS 1964; ChM 1968.

Born
19 June 1934
Brighton
Died
30 April 2016
Pembrokeshire, Wales
Occupation
General surgeon and Transplant surgeon

Details

Anthony ('Tony') Barnes, a consultant surgeon at Queen Elizabeth Hospital, Birmingham, was in the vanguard of renal transplantation in the UK and made major contributions to the establishment of the specialty. He was born on 19 June 1934 in Brighton and as a teenager during the Second World War was evacuated to the East Grinstead area, where airmen who had suffered severe burns were benefitting from pioneering plastic surgery. This influenced his choice of skin allograft rejection for a BSc project during his medical undergraduate training at Birmingham University. He won the Bertram Windle prize in anatomy and gained his BSc with first class honours, subsequently winning the prize in surgery for three successive years before graduating in 1958.

After house jobs, he again studied graft rejection at East Grinstead with Sir Peter Medawar, encouraged by Sir Solly Zuckerman, then professor of anatomy in Birmingham. Both encouraged a scientific career, but Tony was committed to surgical training and progressed rapidly to a lectureship in the department of surgery at Birmingham University under Alphonsus ('Pon') d'Abreu at Queen Elizabeth Hospital.

Experiments in renal transplantation had progressed through the 1950s, but did not become a practical solution to the problem of kidney failure until the introduction of immunosuppressive drugs in 1964. At that time haemodialysis remained the only treatment option for kidney patients in most parts of the UK including the Midlands. After visits to Boston and later Cambridge and St Mary's, Tony resolved to introduce a transplantation programme to Birmingham. In 1968, whilst still a lecturer, having identified a potential first recipient, he was called to a recently deceased donor at a local hospital and duly returned to Queen Elizabeth Hospital with two kidneys. With d'Abreu away, he had to persuade his consultant seniors to proceed with the transplant. Ultimately this was a team effort with Geoffrey Slaney performing the arterial anastomosis, Frank Ashton the venous and Paul Dawson-Edwards the ureteric, leaving Tony to sew up the skin.

A substantive consultant appointment soon followed and Tony rapidly built up one of the most active renal programmes in the UK. Like many of his contemporaries in the newly-established transplant units, he was single-handed for the first 14 years and relied on his trainee registrar to share the busy workload on a full-time on-call basis, regarded by all as character-building rather than unsafe. Tony often stated that working for him on the kidney unit was the ideal contraceptive. Nevertheless, the outstanding training he provided meant that the transplant registrar post was much sought after. All Tony's trainees carried their experience on to successful independent careers as consultant surgeons, several of them in transplantation.

Developments in tissue typing showed that recipient-matched kidneys were less prone to rejection, thus sharing kidneys between centres had clear advantages. The first national matching and sharing scheme, the National Organ Matching and Distribution Service, was set up in 1972 and Tony chaired this for several years. This later merged with the National Tissue Typing and Reference Laboratory to become the UK Transplant Service. In conjunction with the Birmingham local newspapers, he was instrumental in establishing the first donor card programme in the UK, as well as contributing to the acceptance of brain death criteria.

He was a founder member of the British Transplantation Society and was elected meetings secretary at the inaugural gathering in 1972. He also supported the transplant sports movement and managed the British team to success at the first International Transplant Games in 1980, the year in which he was nominated Midlander of the Year.

He later assumed responsibility for surgical training in the West Midlands when serving as a regional adviser for the Royal College of Surgeons of England, introducing an element of devolution to the process of placing senior registrars in the posts most likely to help complete their training and so become consultants themselves. Throughout his career he published widely, an early highlight being his delivery of an Arris and Gale lecture at the College in 1969 entitled 'Genetic studies of the transplantation antigens'.

In addition to renal transplantation, Tony was accomplished in all aspects of general surgery. His surgical skills were legendary. On one occasion, when evening social events for consultants still took place in the NHS, he was called to repair a ruptured aortic aneurysm. He left during the dinner main course, but was back in time for the cheese course, the aneurysm safely repaired. His experience in the renal failure population helped him establish the principles of parathyroid surgery and he served as president of the British Association of Endocrine and Thyroid Surgeons from 1995 to 1997.

Whilst postgraduate tutor, he led a successful appeal for the funding of a purpose-built postgraduate centre for the Queen Elizabeth Hospital; a building that was eminently fit for purpose and attracted architectural plaudits was rapidly built and commissioned. With his combination of surgical pragmatism and modernising zeal, Tony was unafraid to challenge the medical establishment and his numerous innovations were accomplished regardless of personal ambition.

He retired to his beloved cottage in Pembrokeshire, where, with his wife's help, he became a plantsman, establishing a six-acre arboretum, which included the second most significant national collection of Ilex (holly) in the UK. This was featured in a an edition of BBC Radio's Gardener's Question Time, broadcast in October 2011. Other lifetime interests included fishing and opera. After the nature of his final illness was known, he died peacefully at home on 30 April 2016 with family around him. He was 81. He was survived by his widow Pat and three children Simon, Louise and Joanna.

John Buckels
Malcolm Simms

Sources used to compile this entry: [Personal knowledge; Pat Barnes; BMJ 2016 353 2959 www.bmj.com/content/353/bmj.i2959 - accessed 5 August 2016].

The Royal College of Surgeons of England