Medicine: Progress in Transplants

Medical scientists this week reported a major advance toward one of their most cherished goals: the ability to replace diseased or worn-out human organs. Writing in the New England Journal of Medicine, a team of doctors from Harvard Medical School and Peter Bent Brigham Hospital described the first successful attempt to graft a man with a kidney from somebody other than an identical twin. The patient is alive and healthy after 18 months-long enough to suggest that he has a chance of living a near-normal life. Led by Dr. John P. Merrill, the doctors succeeded by subjecting the patient to what they call "heroic measures": an almost killing dose of radiation. They are well aware that this is not the final answer. They want less drastic, probably chemical, means of making grafts "take." The search is already under way, and will be speeded by the preliminary success now reported.

The first serious attempts to transplant organs by modern surgical techniques began in the early 1900s, when pioneering Dr. Charles Claude Guthrie, working at St. Louis' Washington University, created two-headed dogs by grafting. Today most of the surgical techniques have been perfected. Such surgeons as Stanford's Norman E. Shumway Jr. have developed grafting to the point where a dog with an unrelated dog's transplanted heart is up and hopping around within 24 hours, but it dies within three weeks.

The difficulty—and the reason doctors rarely try organ grafts on humans—is biochemical. One of nature's inexorable laws is that the mammalian body (like all animals' from amphibians up) will reject, attack and eventually destroy any invading material from another individualn.* In experiments with dogs, and in the few attempts on humans, this "rejection reaction" has invariably killed the graft. Only in the case of identical twins, who are in effect the same person biochemically, have grafts of skin or organs been completely successful. Since 1954 the Harvard-Brigham team has performed eleven successful kidney transplants between identical twins. But in 17 other cases where they tried to get the same result outside the identical-twin relationship, the transplanted kidney was rejected, and the patient died. That was until John Riteris came along.

Fraternal Grafts. Latvian-born son of an engineer father and a dental surgeon mother, John Riteris, 24, was found to have kidney disease while in the Army, was discharged and went home to Milwaukee. Easily tired, always short of breath, he developed severe high blood pressure, a failing and enormously enlarged heart, "dropsy" and anemia. When his 6-ft. frame was down to 98 Ibs., doctors despaired of saving him.