City at the cutting edge of a medical marvel

[okarol]

City at the cutting edge of a medical marvel

Published Date:
28 October 2010
By SANDRA DICK
Chief Writer

THE operation was life-saving and the gift from her mother one that Linda Phillips would only truly begin to understand many years later.
But when the little girl slowly opened her eyes after undergoing surgery to remove damaged kidneys and replace them with a healthy one from her mum, all she knew was that suddenly she felt so much better and, for the first time in months, she was actually hungry.

Linda was just nine years old at the time. It was the Sixties, before man had walked on the moon and hippies were enjoying the summer of love, when the notion of transplanting one person's kidney into another's body - ultimately saving their life - was still regarded by some as the stuff of science fiction.

Of course, Linda had no idea at the time that she and her devoted, selfless mum Marie were part of a unique pioneering group of patients, among the first in the country to undergo life-saving surgery which today is almost regarded as an everyday area of NHS care.

Now, 50 years to the day since Edinburgh clinicians secured their place in the history books by performing the UK's first ever kidney transplant, Linda has returned to the Royal Infirmary to give thanks for the groundbreaking efforts that saved her life and to add her support to new calls for more registered donors.

"I had no idea at the time what was going on," says Linda, 53, who received her mum's "living donor" kidney in 1967, while medics were still perfecting the intricate surgery and its equally delicate aftercare. "All I knew when I woke up was that for the first time in ages I was hungry.

"My mum came to see me and I couldn't understand why she was in a wheelchair - I didn't know she'd had surgery to give me her kidney.

"She broke into tears when she saw me munching my way through a packet of biscuits - that was all the proof she needed that I was finally getting better."

Just a few years before Linda's transplant, clinicians had celebrated the remarkable medical first when identical Leith twins Lewis and Martin Abbott, 49, went under the surgeon's knife on October 30, 1960.

Lewis, a steel worker, had irreversible kidney failure. Luckily, Martin appeared to be a perfect match. Along with the late lead surgeon Professor Michael Woodruff and a dedicated team of medics, they changed the face of modern medicine.

Dr Bernard Nolan, senior registrar at the time who assisted Professor Woodruff during the transplant procedure at the Royal Infirmary, recalls it as a "truly memorable day".

"I assisted with the first operation to remove the kidney from the donor and then had the task of carrying it through to the recipient before I assisted Professor Woodruff with the second operation.

t was probably one of the most rewarding experiences of my life watching the recipient grow back to full strength."

The operation was hailed a huge success across the UK and the twins returned to their normal lives within weeks. They lived for six years before both died from unrelated diseases.

Dr Anne Lambie, a lecturer in therapeutics at the time who helped with the pre-operative treatment, says the day of the first transplant was an exciting time: "The operation was the beginning of things to come and it was very exciting for all of us to be involved.

"It was a breakthrough. The team was the first to perform the procedure in the UK and it was fascinating for us to watch Lewis get better and be given his life back, although he seemed to take it all in his stride."

There was much more to the procedure, however, than the operation alone and the fine balance of aftercare for patients took years to perfect.

Linda, whose kidneys were damaged as the result of a virus when she was seven, remembers being given a massive cocktail of steroids to help stave off infections, which affected her weight and her health in other ways.

"I ended up like Bessie Bunter. I put on so much weight that my best friend didn't recognise me," she recalls. "I suppose we were guinea pigs because having got the operation right, they now had to figure out how to stop people rejecting the new kidney. But it was a small price to pay for having my life back."

Linda, of Eskdale Mews, Musselburgh, went on to have two children thanks to the recovery sparked by her mum's kidney. However the transplanted organ started to fail around eight years ago and Linda is now back on dialysis and waiting for a second transplant.

"Mum lived to 85, and her kidney did an amazing job before it started to fail," she says. "What she did was incredible. It must have been a huge decision for her and my dad - they had my three brothers to think of as well.

"Afterwards, mum said I had two birthdays, my real one in June and January 5 - the date of my transplant which saved my life."

The ERI's John Forsythe, national lead transplant surgeon, says the UK's first transplant marked a new era in medicine.

"The bravery of the twins and the work of Woodruff and his team showed we could overcome the surgical problems of transplant and since then we have gradually overcome many of the problems of rejection. This means that transplant is now one of the most successful modern procedures.

"Since that first operation there have been further significant medical advances. We can transplant between people who do not have good tissue matching, such as spouse to spouse or "stranger" donation.

"The donor operation has also changed completely and now most kidneys are removed by keyhole surgery."

Around 130 kidney transplants are performed at the ERI every year.

However, around 800 people in Scotland - 8000 in the UK - are on the transplant waiting list.

Transplant patient Mary Cunningham, 59, of Pirniefield Bank, Leith, is among the few to have personal experience of exactly how the surgery has developed through the years.

Her kidneys failed to grow properly and she had her first transplant in 1965 aged 14. It worked well for 18 years but by early 1984 Mary's health had deteriorated and she underwent two years of haemodialysis before receiving her second transplant in 1986.

Sadly she suffered from a string of other health complaints, ironically some of them linked to the early post-operative medication.

"I was young and I was very ill when I got my first transplant," she says. "I wasn't terribly aware of what was going on but it must have been terrifying for my parents. The only one thing doctors could do was give me a transplant. Without it, I would have definitely died."

Like Linda, she was put on a cocktail of drugs as medics experimented in the hope of finding the right combinations to stop the new organ being rejected.

"They didn't know then what they do now, so I suppose in some way I was a bit of a guinea pig," adds Linda. "At the end of the day, though, I wouldn't have been here. Looking back now, you realise how new and pioneering and amazing it was."

Donors wanted
The world's first kidney transplant took place in Boston in 1954. Surgeons in Edinburgh performed the UK's first such procedure six years later.

Today around 130 kidney transplant operations are performed at The Royal Infirmary every year.

The 50th anniversary comes as NHS Lothian launches a campaign to increase the number of registered organ donors. A dedicated website has been created and donors can also join by texting "fifty" on their mobile phone to 61661.

http://edinburghnews.scotsman.com/features/City-at-the-cutting-edge.6602812.jp?articlepage=1