Sir Roy Calne was the father of immunosuppression in transplant patients, having developed the drug regimens needed to make the grafts last. These protocols were originally created for kidney transplants, but this knowledge was rapidly applied onto the transplantation of other organs: it paved the way for heart, lung, liver, pancreas and kidney transplantation to become standard procedures throughout the world, thereby benefiting huge numbers of patients. For all this, Sir Roy Calne has received several awards and has written his part in the history of modern medicine.
For the average medical student of today, the world without transplantation does not exist. It has become the last hope and the ultimate solution when nothing else is possible to save a patient’s organ, or when his life is at stake. Sir Roy Calne was a junior doctor in a very different time, when he was told a kidney transplant for a dying man was not possible.
In 1959, after qualifying at Guy’s Hospital in London, and working at a number of hospitals in the area, Sir Calne had a chance to return to this subject at the Royal Free Hospital and the Royal College of Surgeons, where he started to work on the technique of kidney grafting and the obstacle of rejection. He found that human kidney transplants had been attempted but all had failed, except for an identical-twin kidney graft carried out by Dr. Joseph Murray at the Peter Bent Brigham Hospital in Boston. The challenge was to find a strategy to suppress the immune response that caused the failure of the grafts. Following his studies, he was able to describe the first effective immunosuppression using 6-mercaptopurine for kidney transplantation. After these first encouraging results, in 1960, he received a Harkness Fellowship to continue his studies at Harvard Medical School, where thiopurine drugs were further developed experimentally, and the most effective compound, Azathioprine, was then applied to the treatment of human patients at the Peter Bent Brigham Hospital in Boston, in 1962.
Sir Calne was appointed Professor of Surgery at the University of Cambridge and Fellow of Trinity Hall General Surgeon, with a special interest in organ transplantation, in 1965. In this same year, he started the kidney transplant programme in Cambridge and described the tolerance phenomenon in pigs. A few years later, he also started the liver transplant programme.
Another breakthrough in immunosuppression for transplantation was reached with the introduction of cyclosporine, in 1978. Before his experiments with this drug, there were only about 10 centres across the world performing transplants, however, after Sir Roy showed what could be done with it, there were more than 1,000.
His team was also responsible for the world’s first liver, heart and lung transplant, in 1987, and for the first successful combined stomach, intestine, pancreas, liver and kidney cluster transplant, in 1994.
Due to all these discoveries that changed modern medicine, Sir Calne was made Knight Bachelor in 1986 and has received many awards since then, including the Lister medal for his contributions for surgical science, in 1884; the Ellison-Cliffe Medal from the Royal Society of Medicine in 1990 and shared the Lasker-DeBakey Clinical Medical Research Award with Thomas Starzl for the development of liver transplantation, in 2012. In 1995, the British Transplantation Society incepted the “Sir Roy Calne Award” in his honor.
Nowadays he is still working, as the Yoah Ghim Professor of Surgery at the National University of Singapore, and involved in collaborative research with the University College London and the Cambridge Medical School on the experimental development of gene therapy for treatment of diabetes.
Besides his scientific work, Sir Calne is also an artist, particularly of depicting the theme of transplantation and healthcare in his oil painting. He is a member of the Art Group 90 and exhibited in England, USA, Germany, Canada, Japan and Singapore. He has also written books on general surgery, organ transplantation and art. The most recent is “The Ratchet of Science or Curiosity Killed the Cat”, which outlines the extraordinary progression of science in the last fifty years for good and for potentially destructive applications, of which the scientist – the protagonist – has no control, but has still the responsibility to attempt to channel applications aimed towards peace. Before that, in 1994, he published “Too many people”, where he discusses his point of view on population growth and sustainability.
He also is a keen advocate for organ donation, raising awareness for the insufficient numbers of organs available for transplantation.
I thought the awards were a wonderful opportunity to try and explain we are still very short of donors in the UK. A month ago I met a lady who had a kidney transplant 44 years ago in Cambridge after a road traffic accident. She is still in excellent health. Organs give a fantastic quality and gift of life. We need donors.
Sir Roy Calne upon receiving
the Pride of Britain Award, in 2014
In his lecture at the iMed Conference® 8.0, Sir Calne will give us a glimpse of his path in these last 50 years of a singular and amazing career, the science produced and the clinical outcomes that have benefited so many people so far and will carry on doing so in generations to come.