“Well, I've always tended to hate being told that something can't be done,” Dr. Kalne said in a New York Times interview years later. Dr. Calne, who died on January 6 at the age of 93, revolutionized transplant surgery and pioneered the use of drugs and surgical techniques that gave hope to millions of people for whom organ failure was a death sentence.
He, along with another visionary surgeon, Thomas E. Starzl from the United States, in turning a risky experimental procedure into a widely accepted treatment, performed some of the first liver and multi-organ transplants even as his colleagues were reluctant to support his research.
“The reason I'm here today, the reason I'm able to do my job, is because these two people went to the source,” said Srinath Chinnakutla, surgical director of the liver transplant program at the University of Minnesota. “They were really brave in going against the paradigm of the time. If they hadn't taken those risks, we wouldn't have been able to do a liver transplant at all.”
When Dr. Kalne began his research into organ transplantation in the 1950s, he faced two major problems. One was about technology: How do you remove a defective kidney or liver and then replace it with a working organ? The second is biological: How do you circumvent the body's immune system, which rejects foreign tissue and treats it like an invading enemy?
Early efforts were far from promising. Dr. Kalne performed surgery on animals, especially dogs and pigs, which died almost instantly. Animal rights activists who discovered the actions sent him a bombshell. “I was skeptical and called the army – who blew it up,” he told The Times in 2012.
Dr. Calne attempted to stifle the dogs' immune systems through radiation, causing them to become ill. He then turned to medications, using an anti-leukemia agent called 6-mercaptopurine while performing kidney transplants in 1959. This time, one of the dogs lived for more than a month without rejecting the new organ. He added: “This changed what was a miserable failure into a partial success.”
While Starzl developed surgical techniques in Colorado and then in Pittsburgh, Dr. Calne followed his example a continent away. In 1968, a year after Starzl performed the world's first successful liver transplant, Dr. Calne performed the first successful liver transplant in Europe while working as a professor of surgery at the University of Cambridge.
By the mid-1970s, Dr. Calne was testing a new immunosuppressive drug, cyclosporine, which was being promoted by Jean-François Borel of the Swiss pharmaceutical company Sandoz. Dr. Kalne led the first major study on its clinical uses, discovering that the drug increased the one-year survival rate of kidney transplant patients from 50 percent to 80 percent.
Cyclosporine became a standard part of organ transplant procedures — Starzl later discovered another effective immunosuppressant, FK-506 — and was credited with transforming attitudes toward surgery that had previously been considered, in Dr. Calne's words, “a project for mad surgeons.” Ignorant about immunology, who didn't really know what they were doing.
“The discovery and use of cyclosporine has made transplantation possible as a treatment for an increasing number of people,” said John Wallwork, a fellow transplant surgeon, in his tribute. “Nearly 50 years later, this is still what is used for transplant patients today.”
Together, Dr. Kalne and Wallwork performed the world's first successful heart, lung, and liver transplant on the same patient, a 35-year-old housewife, in 1986. Eight years later, Dr. Kalne led the team that performed the first “combination” transplant, a patient's stomach replacement. The small intestine, liver, pancreas and kidneys.
Dr Kallen was knighted in 1986 for his contributions to medicine – he was widely known in Britain as Sir Roy – and received the Lasker Prize, considered the highest honor in medicine after the Nobel Prize, with Starzl in 2012. The surgeons are jointly awarded the Lasker-DeBakey Clinical Research Award for their research in the field of liver transplantation.
Dr Kalne said at the time that the honor was gratifying, even though he was trying to find satisfaction elsewhere. “I have a patient and it's been 38 years since he's had a transplant,” he told The Times. “He just got back from a 150-mile bike ride through the mountains. This is my reward.”
Roy York Calney, the eldest of two sons, was born in the town of Richmond, now part of London December 30, 1930. His father was a former engineer for the Rover Motor Company, and his mother was a housewife. His brother Donald became a Canadian neurologist and leading expert on Parkinson's disease.
After graduating from Lancing College in West Sussex, Dr Calne joined Guy's Hospital Medical School in London when he was 16 years old. He qualified as a doctor in 1952, according to a Lasker Award biography, and served as a military doctor in Southeast Asia for a year. A few years before he returned to England, he was appointed to teach anatomy at Oxford University.
While there, he attended a lecture by biologist Peter Medawar, a future Nobel laureate, who discussed the results of successful skin grafting among mice. The trial suggested the possibility of manipulating the immune system, although Medawar insisted there was “no clinical application at all.”
But Dr. Kalne thought otherwise, and asked himself: “Why can't we do something like this with kidneys?”
He began work in kidney transplantation at the Royal Free Hospital in London, and continued his research through a fellowship at Harvard's Peter Bent Brigham Hospital in Boston, where the first successful kidney transplant on identical twins was performed in 1954.
In 1965, he joined the University of Cambridge, where he was Professor of Surgery until his retirement in 1998. Dr Calne continued to perform kidney transplants into his 70s and carried out medical research into his 80s, including the use of gene therapy to treat diabetes.
The British Organ Transplantation Society and the University of Cambridge announced his death at a nursing home in Cambridge, without giving a reason. Survivors include his wife, the former Patricia “Patsy” Whelan, whom he married in 1956; six children, Deborah Chittenden, Sarah Nicholson, Richard, Russell, Jane and Susie Calney; his brother; And 13 grandchildren.
Dr. Kalne said that although he had no qualms about performing organ transplants on people in need (“If you come to me in pain and fear, it is my duty to help you”), he was wary that medical advances may have inadvertently contributed in that. To population increase. In 1994, he published Too Many People, in which he argued that the world had become overcrowded and proposed legal controls on parenting, including the creation of a “potential permit to procreate”.
In promoting the book, he told the Sunday Times of London that if he were to start a family today, he would stop at two children instead of six. If his children want large families of their own, he added: “I will give them a copy of the book.”
Between surgeries, Dr. Calne relieved stress by playing squash and tennis. He also turned to painting, expanding his palette with the encouragement of one of his former patients, the Scottish artist John Bellaney, who painted Dr Calne for the National Portrait Gallery in London after he turned surgeon for a liver transplant in 1988. He later painted many of his patients, with their permission, on canvases Which decorated the walls of his home and office. Some of his photographs were displayed at the Barbican Center in London in an exhibition entitled The Gift of Life.
The photographs captured the patients' pain, wrote journalist Lawrence Marks in a 1994 profile for The Independent, “but they captured something else too: the essence of his extraordinary partnership with them. He needs their endurance, their courage, their confidence. They need his knowledge, his candor, his humanity. Their haunted faces are reminiscent of those of In paintings in the Imperial War Museum of soldiers emerging from the trenches.
