A Pair of Lifesavers

By MICHAEL D. LEMONICK

The transplanting of organs and tissues -- hearts, kidneys, lungs, bone marrow -- has become such an accepted part of medical practice that it is hard to remember when the technique was considered highly dubious. But as recently as the early 1950s, many doctors thought transplants would never be possible.

Thanks to breakthroughs by a few researchers, the doubts have long since vanished. Last week the Nobel committee recognized two of those early pioneers. The Nobel Prize in Physiology or Medicine will go to Joseph Murray of Boston's Brigham and Women's Hospital, who performed the first successful transplant of a human organ -- a kidney -- in 1954, and to E. Donnall Thomas of the Fred Hutchinson Cancer Research Center in Seattle, who in 1956 was the first to transfer bone marrow from one person to another. They will split approximately $700,000.

The award was something of a departure for the committee. It usually recognizes basic medical research, like the discovery of the structure of DNA, rather than clinical treatments. But in this case, the benefit to humanity, a primary consideration, was clear: Murray's and Thomas' discoveries are "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," read the committee's citation.

! Dr. Murray became intrigued with the idea of transplants during a stint as a plastic surgeon in World War II. "We took care of thousands of casualties, many with severe burns," he recalls. "I was performing skin grafts and became interested in why skin wouldn't graft permanently." Such grafts did work, however, on identical twins, and Murray suspected that the same might be true for internal organs. After experimenting on dogs, he performed his first kidney transplants between twins, and as expected, the recipient's immune system did not reject the new organ as an invader. Later, Murray experimented with drugs that suppressed the immune system and thus allowed transplants from close relatives and even unrelated cadavers.

Dr. Thomas' focus was on leukemia, at the time an inevitably fatal cancer of blood-forming tissues. Because blood cells are generated by bone marrow, he reasoned that replacing a patient's marrow with that of a healthy donor might arrest the disease. Like Murray, he worked first on dogs, destroying the animals' own marrow with radiation, then transplanting new cells through the blood. He too found that at first the only successes in humans came with identical twins -- and that immunosuppressive drugs, as well as careful tissue matching, could overcome rejection.

After his work on kidneys, Murray returned to his original specialty, concentrating on plastic and reconstructive surgery for children born with facial deformities. Thomas went on to become the director of oncology at the Hutchinson Center. The two doctors' strongest boosters may be each other. They first met during their residencies at the Peter Bent Brigham Hospital (now part of Brigham and Women's Hospital) in Boston in the late 1940s, and have remained friends ever since. Says Thomas of his colleague's prize: "I thought that was wonderful news. I've admired his work for years." Concurs Murray: "It doubles the pleasure. I couldn't be happier."

With reporting by Margaret Emery/San Francisco