Making— and remembering— transplant history

By Michelle Martin
Staff writer

When Dr. James W. West cut into the still-warm body of a woman to remove a kidney and transplant it into a waiting patient, he didn’t really know what to expect.

West, working with doctors Richard H. Lawler and Raymond P. Murphy, had practiced the surgery on cadavers many times, but no one had ever successfully transplanted an organ from one human being into another.

The date was June 17, 1950, and the place was Little Company of Mary Hospital in Evergreen Park.

At the time, the surgeons were on the faculty at Loyola University’s Stritch School of Medicine and Cook County Hospital, but they never approached the teaching hospitals about the case.

“What we needed,” West said in a September interview, “was the trust of the sisters. The sisters of the Little Company of Mary knew us well enough to trust us with doing this radical, bizarre operation.”

West, 90, now lives in California. The only surviving member of the surgical team, he came to the Chicago area to be honored for 65 years of service to Little Company of Mary Hospital Sept. 15

The surgery was a last resort for Ruth Tucker, 44, who had moved to Chicago from Indiana to get better care for her polycystic kidney disease. Tucker had watched her mother, sister and uncle die in their 30s and 40s from the same disease, and her kidneys had nearly stopped functioning when she was referred to Lawler.

Doctors around the world had been experimenting with organ transplants in animals since the turn of the century, and Lawler was interested in the idea. The difficulties were matching blood and tissue types, and finding ways to stop the recipient’s body from rejected the donated organ.

The surgery was so experimental that neither the doctors nor the hospital told anyone that they had attempted it, West said.

“We wanted to make sure she survived the surgery and didn’t die from an allergic reaction or anything like that,” he said.

But word leaked out when one of Tucker’s relatives mentioned the case to a friend at a Chicago-area newspaper. Tucker was doing well several days after the operation, so the hospital and doctors went public and made headlines around the world.

“This was very controversial,” West said. “Even in the medical community. We had many doctors who supported it, but many were against it. The clergy in particular opposed this procedure—they were opposed to the idea that you could take tissue from someone who was dead and put it in someone who was alive and it would come back to life. It was like, once it was dead, it should stay dead.”

That opinion has changed as medical advances have made organ transplants more common, the church has taken a public stance in support of organ donation.

In 2003, there were more than 15,000 kidney transplants in the Unites States, with more than 57 percent coming from deceased donors, according to the United Network on Organ Sharing.

The biggest change came in the development of better matching between donors and recipients and the development of anti-rejection drugs.

While doctors matched Tucker to her donor as well as they could, they did not have the sophisticated tests or the anti-rejection drugs they have now. .

Even so, the donated kidney functioned in Tucker’s body for about six weeks, West said. That was enough for her other kidney to begin to work again, and she survived more than five years after the surgery before succumbing to the disease.

During that five years, transplant research and experimentation continued. There were several attempts in France, using kidneys from people executed by guillotine, West said, and then Harvard University attempted the first living-donor transplant in 1954, transferring a healthy kidney into the body from one man into his identical twin, who was dying from kidney disease. Because the two men had the same genetic make-up, there was no rejection to deal with, West said, and the recipient lived nine more years.

Harvard doctors kept working on the problem, and by 1960, had developed cyclosporin to fight rejection. It and similar drugs now are used in combination with anti-inflammatory drugs, West said.

West said he and his colleagues always hoped that organ transplants would become a realistic option, and it was the development of anti-rejection drugs that made that possible. But rejection remains a problem. Last year, more than 11 percent of the kidney transplants performed were repeat surgeries on patients who had already received one donor organ.

Despite the honors he has received for his work on the transplant team, West actually devoted much of his career to and is best-known for his work with substance abuse patients. When he became interested in the problem in the 1960s, he studied psychiatry, eventually teaching psychiatry classes on the topic at Rush Medical School in Chicago. He helped Msgr. Ignatius McDermott found Haymarket House, a Chicago treatment center, and then became medical director at the Betty Ford Center in Rancho Mirage, Calif. He continues to work there, developing treatment plans for patients.

West credits his decision to become a doctor to a speaker at a retreat at his Jesuit high school in Prairie du Chien, Wis. One of the presenters told the students that they needed to decide what they were going to do with their lives. West said, he stayed behind in the chapel to think about it. He made his decision to become a doctor that day.

“From then on, it was easy for me to be a doctor,” he said. “It was already there in my mind. Everything else was just an obstacle to overcome between me and the M.D.”