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Introduction of Rene KÜSS

Starzl, Thomas E. M.D., Ph.D.

doi: 10.1097/01.TP.0000063276.39381.9F
SPECIAL LECTURES

Department of Surgery, Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA.

Address correspondence to: Thomas E. Starzl, M.D., Ph.D., Professor of Surgery, Thomas E. Starzl Transplantation Institute, University of Pittsburgh, 3601 Fifth Avenue, Pittsburgh, PA 15213. E-mail: mangantl@msx.upmc.edu.

During an historic 12-day period, between January 12 and January 20, 1951, in Paris, Rene Küss, Charles Dubost, and Marceau Servelle first performed the extraperitoneal renal transplant procedure in common use today (1–3). Oeconomos and Rougeulle, who were members of the Dubost and Servelle teams, had helped Küss develop the operation in the experimental laboratory. Consequently, all those involved acknowledged the primary role of Küss, whose name is often attached to the procedure (the “Küss operation”). Dubost and Servelle obtained their renal allografts from the same guillotined convict donor, whereas Küss used a free kidney that had been removed from another patient for therapeutic purposes.

A total of nine kidneys were transplanted. When all nine grafts were rejected, Küss concluded in an article, published in 1952, that, “. . in the present state of knowledge . . the only rational basis for kidney replacement would be between monozygotic twins . .” (4). The prediction was validated by Joe Murray’s identical twin transplantation 2 years later.

The transition to allografts was signaled by the successful transplant of fraternal twin kidneys, first by Murray in Boston in January 1959 (5), then 5 months later by Hamburger’s Paris team. For the next 3 years, the French experience provided the principal if not the only justification for continued clinical efforts in renal transplantation (6,7) (Table 1). Küss added two crucial examples of >1-year survival after the transplantation of nonrelated kidneys on June 22, 1960, and March 12, 1961 (6), whereas Hamburger’s team reported two non–twin-related cases (7). All six patients had been prepared with sublethal total body irradiation. However, Küss’s patients were subsequently treated with 6-mercaptopurine and prednisone, setting the stage for the era of drug immunosuppression.

Table 1

Table 1

Küss was the son of a distinguished surgeon and the grandson of a famous mayor of Strasbourg, and he was indoctrinated with a strong sense of moral and social responsibility. He graduated from the University of Paris School of Medicine and served as a surgical resident at the Broca Hospital, Paris, under the chief of service, Professor Proust, the brother of the famous philosopher-author Marcel Proust. During World War II, Küss was a physician in the doomed French navy and was a physician-in-chief on the destroyer Mogador that was bombed and sunk off the coast of North Africa in July 1940. He later led the surgical team of General George Patton’s 3rd American army and participated with the French resistance in the liberation of Paris (using hand grenades as well as scalpels). He received the War Cross with Palm.

After the war, Küss became a urologist at Cochin Hospital, where his historic kidney transplants of 1951 were performed. While creating multiple departments of urology in Paris hospitals in the succeeding years, he made monumental contributions to general urology. Many of the sophisticated techniques that are used today in dealing with unusual problems of urinary drainage or vascular reconstruction in transplant cases were developed or promulgated by him. In 1966 at Saint Louis Hospital, he made an historic effort to transplant a pig xenograft with the assistance of Jacque Poisson. In 1972, Küss quit private practice to concentrate full time on the development of the legendary urology clinic at the University Hospital Pitié Salpetriere. In the same year, he founded the French Society of Transplantation. He retired from clinical duties in 1985. In the 1990s, he served as President of the French National Academy of Medicine.

However, it would be inappropriate to define Küss’ life solely in these professional terms. He was a racecar driver and competed in the exhausting Rally de Monte Carlo. Very early, he was introduced to art by his father, subsequently gathered a remarkable private collection of ancient and modern paintings in Paris, and organized exhibitions at the seaside village of Honfleur where he made his second home. His care of these treasures, his beautiful wife, his four children, and now his grandchildren have filled his life over a span of 89 years to a level almost never achieved by any man or woman. I proudly introduce Rene Küss: Professor Emeritus of the University of Paris, Past President of the French National Academy of Medicine, Commander of the French Legion of Honor, and now a 2002 Medawar Laureate of the Transplantation Society.

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REFERENCES

1. Küss R, Teinturier J, Milliez P. Quelques essais de greffe rein chez l’homme. Mem Acad Chir (Paris) 1951; 77: 755–764.
2. Dubost C, Oeconomos N, Nenna A, et al. Resultats d’une tentative de greffe renale. Bull Mem Soc Med Hop Paris 1951; 67: 1372–1382.
3. Servelle M, Soulié; P, Rougeulle J, et al. Greffe d’une rein de supplicie a une malade avec rein unique congenital, atteinte de nephrite chornique hypertensive azatemique. Bull Mem Soc Med Hop Paris 1951; 67: 99–104.
4. Küss R. Greffes de reins: Extrait des Entretiens de Bichat, volume Chirurgie. 1952.
5. Murray JE, Merrill JP, Dammin GJ, et al. Study of transplantation immunity after total body irradiation: Clinical and experimental investigation. Surgery 1960; 48: 272–284.
6. Küss R, Legrain M, Mathé; G, et al. Homologous human kidney transplantation: Experience with six patients. Postgrad Med J 1962; 38: 528–531.
7. Hamburger J, Vaysse J, Crosnier J, et al. Renal homotransplantation in man after radiation of the recipient. Am J Med 1962; 32: 854–871.
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