One man gave his twin brother the ultimate Christmas gift and made medical history.
Caitlin Stier
On December 20, 1954, just as Joseph Murray, a surgeon at the Peter Bent Brigham Hospital in Boston, started to prepare the eggnog for his holiday party, he received the phone call he had been waiting for: a cadaver was available at the hospital. Murray immediately left his home in Wellesley, MA, and made the snowy trek into the city to do a trial surgery on the cadaver. Murray was getting ready to attempt what was then thought of as a hair-brained idea: a human kidney transplant.
The patient was Richard Herrick, a 24-year-old Massachusetts native suffering from chronic kidney disease. He was dying and his only hope was his identical twin brother, Ronald, who had agreed to donate one of his kidneys. The Herrick twins presented Murray with a unique opportunity to perform an organ transplant without the immunological rejection issues that had caused past animal trials to fail.
The Herrick twins at the Brigham hospital entrance
Source: Brigham and Women’s Hospital
Ronald and Richard were the closest of friends. At the start of the Korean War, both had enlisted with the military—Ronald joined the Army and Richard the Coast Guard. When their term ended, they planned to live together, but Richard developed the kidney disease and ended up at a military hospital. His family knew death was imminent. In desperation, older brother Van asked Richard’s doctor why he couldn’t donate his kidney. As the doctor explained that the body rejects foreign tissue, he realized that Richard’s identical twin, Ronald, could perhaps save his brother. He arranged for Richard to be transferred to the care of Murray, who had been working on kidney transplantation at the Brigham.
Murray and his colleagues had to grapple with numerous technical and ethical challenges. Was it ethical to remove a kidney from a healthy person for the benefit of a sick person? The team at the Brigham carefully consulted the brothers and various religious leaders. They also confirmed the brothers’ tissue compatibility by grafting skin from one brother to the other. In this time before DNA testing, the doctors assessed the brothers’ genetics by comparing their fingerprints.
On December 22, the eve of the surgery, Richard urged his brother in a note “to get out of here and go home.” He didn’t want Ronald to give up an organ for his sake. But Ronald resolutely stayed and went through with the surgery.
Transplanting the kidney from Ronald to Richard took a total of five and a half hours. At the nephrologist’s bidding, Richard’s diseased kidney was left in place to mop up harmful substances. Murray put the donated kidney below it. (Surgeons removed the diseased kidney two years later.)
To the delight to the attending doctors, the new kidney immediately turned pink once they unclamped the key artery, and urine flowed quickly out of the kidney. The first successful human organ transplant was complete.
In the following weeks, Richard’s condition improved dramatically. That Christmas he was cared for by a dedicated nurse who changed her holiday plans to attend to him. The two later married and spent eight years together, until Richard’s other kidney finally succumbed to the same disease and he died.
The success of Richard’s transplant paved the way for the field of organ transplantation. Murray eventually developed immunosuppressive therapies that made organ transplantation a routine procedure. For this, he earned the Nobel Prize in medicine in 1990. Today, tens of thousands of kidney transplants are performed around the world each year.
Sources:
Murray, J.E., Merrill, J.P. & Harrison, J.H. Renal Homotransplantation in Identical Twins Surg. Forum VI: 432-436 (1955). Reprinted in J Am Soc Nephrol. 12:201-4 (2001).
Morgenroth, Lynda. “Kidney Transplant, 1954.” Boston Firsts: 40 Feats of Innovation and Invention that Happened First in Boston and Helped Make America Great. Boston: Beacon Press, 2006.
Murray, Joseph E. Surgery of the Soul: Reflections on a Curious Career. Science History Publications, Watson Publishing International, Sagamore, MA, 2001.