Basic and translational surgeon scientists are a rare breed. We are frequently arguing for our relevance and place in the fast-paced world of cutting-edge clinical care and laboratory biomedical research. As we think about the merits of the pathway, what better way to seek inspiration then to look to our predecessors, the legends of translational and basic science in surgery. In fact, often surprisingly to many outside of surgery, there are several amazing examples to look to for inspiration and lessons. To highlight those that have had the most significant impact, we made the decision to limit this piece to surgeons who won the Nobel Prize or Lasker Award (sometimes referred to as “America’s Nobel”), and we have excluded neurosurgery, as they have separate academic societies. There are 12 surgeons I would like to highlight over a few blog posts. This first post will include surgeons from the field of Transplantation. The goal of this piece is to provide quick hits for what these legendary surgeons are known for, so if surgical scientist history comes up, you will have more (or for those new to the subject: some) background information for conversation.
Alexis Carrel (1873-1944) was born and raised in France. He is best known for winning the Nobel Prize in Physiology and Medicine before his 40th birthday in 1912, “in recognition of his work on vascular suture and the transplantation of blood vessels and organs.” Carrel began his investigative career as a surgical intern at Lyons Hospital when he first began developing technique for end-to-end vascular anastomoses. The Carrel end-to-end vascular anastomosis was characterized by use of three, triangulating stay sutures, continuous suture, and aseptic technique. This served as the foundation for modern vascular anastomosis techniques. He moved to University of Chicago and then Rockefeller University shortly after that, where he did his Nobel Prize winning work. As was more common at the time, Carrel achieved great things across a very broad swathe of general surgery and the modern-day subspecialties. He studied organ transplantation and developed, with Charles Lindbergh, the first perfusion pump for cold organ storage. In oncology, Carrel cultured sarcoma cells in vitro. He also served as a military surgeon for France in World War I and helped develop the Carrel-Dakin method of treating traumatic wounds. Another interesting and rather unflattering fact is that Carrel believed in eugenics, which based on his position of power and prestige, supported policies of persecution and sterilization of those with developmental and mental health disabilities. While he pioneered methods and technology that are pivotal in clinical transplantation, he had famously predicted that an unknown biological force would prevent successful transplantation in humans, forever.
Joseph Murray (1919 – 2012) was born in Massachusetts. He was a plastic surgeon that is known for winning the Nobel Prize (shared) in Physiology and Medicine in 1990 for, “discoveries concerning organ and cell transplantation in the treatment of human disease.” Specifically, Murray performed the first human organ transplantation in 1954 at Peter Bent Brigham Hospital in Boston. The operation was a renal graft from a living monozygotic twin donor. Murray served in the US Army Medical Corp and developed an interest in cellular mechanisms of acceptance or rejection in skin grafting. After earning his position at the Brigham, he achieved chief of plastic surgery at Brigham Hospital in 1951. He simultaneously took on the effort of surgical leader realizing the dream of clinical transplantation. The first kidney transplant was performed between identical twins. Dr. Murray’s team pushed forward to perform the first kidney transplants in fraternal twins, unrelated patients, and from a cadaver, each of which were landmark accomplishments. Hitchings and Elion worked with Murray and developed early medical immunosuppression with azathioprine. Hume was a surgical scientist who had performed critical pre-clinical studies of cadaveric kidney transplantation in large animal models. Additionally, Murray served on the committee that originally defined brain death, a new and important concept in consideration of organ donation. He founded the national kidney registry which led to the development of the United Network for Organ Sharing (UNOS). Like Carrel, this is an extraordinary amount to achieve and contribute by contemporary standards. Not all these achievements are translational research per se, but all these components were required to bring his translational science, originally developed in pre-clinical models, to patients. He faced heavy criticism with early failures using whole body irradiation for immunosuppression, however, he did not give up on his dream of discovering how to make human transplantation work. In addition to the Nobel Prize, Dr. Murray was elected to the National Academy of Sciences and received the American Surgical Association’s Medal for Distinguished Service to Surgery.
Thomas Starzl (1926-2017) was born in Iowa. He is widely considered the “father of modern transplantation.” Starzl is best known for winning the Lasker Award (sometimes referred to as America’s Nobel, shared) in Clinical Science in 2012 for, “the development of liver transplantation, which has restored normal life to thousands of patients with end-stage liver disease.” He earned his MD and PhD degrees from Northwestern University. His mother’s battle with breast cancer inspired Starzl to pursue basic biomedical research. At Northwestern, he began working with large animal models to develop experimental methods for performing the kidney transplant operation. In 1962, he moved to the University of Colorado and the Denver Veterans Affairs Medical Center, where he established a clinical kidney transplant program. There he significantly advanced surgical techniques and immunosuppression, including early demonstration of efficacy and side effects of calcineurin inhibitors cyclosporine and tacrolimus. Starzl then focused on liver transplantation, achieving the first human liver transplant in 1962, though he faced significant critique from colleagues and clinical challenges with poor survival. With perseverance, he performed the first successful human liver transplant in 1964. Starzl led the University of Colorado Department of Surgery as Chair from 1972-1980. He blazed the trail as a leader in clinical abdominal transplantation, working in Denver until 1980, after which he returned to the University of Pittsburgh. He retired from clinical service in 1991 but continued to contribute to transplantation research. His latter year efforts were focused on demonstration of microchimerism, a state in which donor leukocytes migrate from the graft into the recipient’s tissues and theoretically reduce the risk of graft rejection and simultaneously the need for immunosuppression. The dream of establishing a method for achieving microchimerism in transplant recipients remains elusive. His esteemed recognitions include the Medawar Prize in 1992, the Presidential Medal of Science in 2005, and the Lasker Award in Clinical Science in 2012. He passed away in 2017 at the age of 90, leaving behind a legacy as the most cited researcher in the world as assessed by the Institute for Scientific Information. His contributions to transplantation research are vast, including the discovery and development of immunosuppression solo therapy and combination therapy, as well as advancements in organ preservation and procurement.
Translational research in surgery remains pivotal today in advancing medical science and improving patient outcomes. Our legacy demands it, as demonstrated by the groundbreaking work of surgeons discussed above. Their collective achievements underscore the critical role that surgeon scientists have historically played in bridging the gap between laboratory research and clinical application. Involvement of surgeons in translational research is even more critical now, given uncertainties surrounding the academic mission and corporatization of healthcare. By leading in translational research, surgeons can continue to push the boundaries of medicine and offer new hope to patients worldwide.
Jeremie Lever
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- Legendary Translational Surgeon Scientists Part I: Transplantation - April 30, 2025
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