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Joseph E. Murray, transplant doctor and Nobel Prize Winner, dies at 93

Nobel Prize winner Joseph Murray, 71, of Boston is hugged by his wife Bobby in a San Francisco hotel, October 8, 1990, after learning that he had received the honour for medicine along with another American. Murray discovered how to prevent tissue rejection during human organ transplants.

Court Mast/Reuters

Joseph E. Murray opened a new era of medicine on Dec. 23, 1954, when he removed a healthy kidney from a 23-year-old man and implanted it in the man's ailing identical twin – thus completing the first successful transplant of a human organ.

Murray went on to pioneer techniques that, over the years, changed the lives of tens of thousands of patients who received new kidneys, hearts, lungs, livers or other organs after their own had failed. In 1990, he was awarded the Nobel Prize in Physiology or Medicine.

Among other procedures, he performed kidney transplants involving more than two dozen pairs of identical twins. In 1959, he conducted the first successful transplant to a non-identical recipient, and three years later, the first using a cadaver kidney. He also trained doctors who became leaders in transplantation around the world.

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Murray, 93, died on Nov. 26 at Boston's Brigham and Women's Hospital, where he performed his groundbreaking surgical feat. According to hospital spokesman Tom Langford, the cause was complications of a stroke he suffered a few days earlier.

As director of the Surgical Research Laboratory at Harvard Medical School and at Peter Bent Brigham Hospital in Boston (which became Brigham and Women's) Murray was a leader in the study of transplant techniques, the mechanisms of organ rejection and the use of drugs to thwart it.

Though Murray devoted most of his career to reconstructive plastic surgery, he was most famous as a transplant surgeon, especially after receiving the Nobel. He shared the $703,000 prize with Dr. E. Donnall Thomas, a pioneer in bone-marrow transplantation, who died in October.

Joseph Edward Murray was born on April 1, 1919, in Milford, Mass., the son of William Murray, a judge, and Mary DePasquale Murray, a schoolteacher. He attended the College of the Holy Cross and Harvard Medical School, from which he graduated in 1943. After an abbreviated internship at Brigham, he entered the Army Medical Corps in 1944.

It was his experience as an Army doctor, especially using cadaver skin to treat burned soldiers, that led him to both transplantation and facial reconstruction, Murray said in a 2001 interview. Though the transplanted skin would survive for only eight or 10 days before it would "begin to melt around the edges," he recalled, the experience taught him that tissue from one person might survive for a time in another and that it might be possible to use "tissue from a dead person to save a human life."

So when he returned to civilian life and began practising as a plastic and general surgeon at Brigham, he joined colleagues in investigating the possibilities of organ transplants. At the time, he recalled, organ transplantation was considered such a wild dream that a medical school mentor advised him to abandon the idea as a clinical dead end.

At Brigham, the work "was considered a fringe project," he wrote in his autobiography, Surgery of the Soul, published in 2001 by Science History Publications/USA.

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But he and his colleagues began testing surgical techniques with dogs, removing and reimplanting kidneys. Then, in October, 1954, Richard Herrick – a Massachusetts man dying of chronic nephritis, a kidney disease – was admitted to the hospital, and his doctors referred him to Murray as a possible transplant recipient. The man's identical twin, Ronald, was willing to give him a kidney. Would Murray perform the surgery?

It was a daunting prospect. Murray worried about "taking a normal person and doing a major operation not for his benefit but for another person's," he said in the 2001 interview.

"We were criticized for playing God," he said.

After consulting with clergy members from a range of denominations, and comparing the Herricks' fingerprints to be sure they were identical and not merely fraternal twins, Murray and his colleagues decided to go ahead. They first practised their surgical techniques on a cadaver. The donor kidney "was the only kidney in the universe that was compatible," Murray said, "and I did not want to goof it up for technical reasons."

During the surgery, he wrote later, "there was a collective hush in the operating room" as blood began to flow into the implanted kidney and urine began to flow out of it.

Richard Herrick, who later married one of his nurses, survived until 1962, when he died of a recurrence of his original disease. Ronald Herrick died in 2010 at 79.

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Two other patients were important to Murray's medical career, both professionally and personally.

The first was Charles Woods, a 22-year-old Army flier who had been badly burned in December, 1944 when his plane crashed in Burma (now Myanmar). He was flown to Valley Forge General Hospital in Pennsylvania, where Murray was a junior member of the medical team that treated Woods with scores of skin grafts and operations to reconstruct his destroyed face and hands.

Murray was mightily impressed with his patient's fortitude, pluck and faith, and they stayed in touch over the years as Woods – recovered but still disfigured – reared a family and became a successful businessman in Alabama.

"He taught all of us who cared for him how a will to live can overcome enormous odds," Murray wrote in his autobiography.

The second patient was Raymond Francis McMillan, who was born with Moebius syndrome, a condition involving heart defects and facial deformities so severe that he was abandoned as a child to a mental institution. In 1964, when he was released at age 21, people who knew him referred him to Murray.

Step by step, in a series of operations, Murray and his colleagues reconstructed and repositioned McMillan's jaw so that for the first time he could swallow normally, control saliva and smile. They then repaired his palate and his nose. Other doctors repaired his heart defects.

Although the doctors were never able to give him an ordinary appearance, McMillan took his place in the world. The doctors had encouraged him to earn his high school equivalency diploma and arranged work for him in hospital laboratories.

Surgery had enabled "his inner self to grow and glow," Murray wrote. The title of his autobiography, Surgery of the Soul, was the phrase he used to describe the phenomenon.

In 1971, Murray resigned as chief of transplant surgery at Brigham to concentrate on plastic surgery – a field, he often said with regret, that had become wrongly associated with mere cosmetic procedures.

In this country and abroad, he treated hundreds of children and adults with congenital facial deformities, survivors of drastic surgery for head and neck cancers, and patients with injuries or other problems. He often used techniques pioneered by Dr. Paul Tessier of France to treat Crouzon syndrome, which produces congenital facial deformities.

In 1945, Murray married Virginia Link, an aspiring singer he had met at a Boston Symphony Orchestra concert while he was in medical school.

In addition to his wife, known as Bobby, he leaves three sons, Richard, J. Link and Thomas; three daughters, Virginia Murray, Margaret Murray Dupont and Dr. Katherine Murray Leisure; and 18 grandchildren.

Murray, who lived in Wellesley, Mass., was a prominent summer resident of Chappaquiddick Island, off Martha's Vineyard in Massachusetts, where he and his wife bought a plot in 1970 and camped on it with their family until they could build a house there.

Murray was elected to the National Academy of Sciences and the Institute of Medicine. A Roman Catholic, he was also a member of the Pontifical Academy of Sciences, which advises the Vatican on science issues. He donated his share of the Nobel award to Harvard Medical School, Brigham and Women's Hospital and Boston Children's Hospital, where he had also treated plastic surgery patients.

After he retired, he remained in high demand as a speaker, mostly addressing medical students and telling them to "keep your eye on helping the patient," he said in 2001.

"It's the best time ever to be a doctor," he would tell them, "because you can heal and treat conditions that were untreatable even a few years ago."

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