You have founded the British Transplant games in 1978. Organ transplantation had been far away from being an established treatment at that time. What have been motivations and thoughts at the time leading to the transplant games? Has there been opposition?
PROFESSOR DR. MAURICE SLAPAK: In 1974 I was appointed transplant surgeon at the Wessex transplant unit, Saint Mary’s Hospital in Portsmouth. There was a dearth of donors—the next-of-kin of a deceased potential kidney donor were either not asked or refused to grant the necessary permission for organ donation.
My goal had been to communicate the miracles that organ transplantation provided and by doing so, increase the public support for organ donation.
Quite by chance, a 23-year-old Jersey policeman who was on hemodialysis presented himself in my outpatient session and calmly informed me that life was intolerable. He felt unwell on the day before dialysis, the day immediately after, was unable to play football, and his relationship with a young lady went downhill. Communicating the poor quality of life of this patient in the regional television station in Southampton, supported the success in obtaining a kidney for him locally.
By 4 months, my patient had been a new man: he and his girlfriend enjoyed a happy relationship, he played football, and was happily back at work. I suggested we went for a 7-mile run at a local country club where we were holding a conference and he kept up with me without any difficulty and both my medical colleagues and the club members were astounded.
In the minds of my colleagues, patients who had survived organ transplantation needed special care and mollycoddling; they were looked upon as essentially debilitated, not fit for work certainly, not for sport and should be grateful to be able to lead a safe, sedentary existence.
Two of the leading Japanese newspaper editors read of the impending transplant games in the UK newspaper Sunday People (which I had persuaded to back the first Transplant Olympics) and were certain that this event would produce severe injury or mortality amongst people who should never have been asked to undertake intense physical activity.
They therefore sent two journalist teams who could only report on fun and competitive games with participants who occasionally slipped and fell on grass only to pick themselves up and continue the race.
Transplantation: How did early Transplant Games look and how many participants were at the games?
PROFESSOR DR. MAURICE SLAPAK: Dubbed the 99 blooming miracles by Sunday People the competitors came from 12 UK centers and centers in USA, France, Mexico and Israel (Figure 1).
Participants had been between 17 to 58 years and had received a kidney transplant more than 12 months before the games; their transplant function was certified as satisfactory by their general practitioners and then carefully verified by our own medical specialist. It was a very low-key event held on a grass field without a running track but with lots of casual onlookers as it was close to the shore in Southsea.
Transplantation: What have been personal moving moments for you during the Games? What have been special relationships that have been built with and between participants?
PROFESSOR DR. MAURICE SLAPAK: Children running—their parents watching with wonder and remembering how debilitated that child had been before transplant. The respect and liking which one sees building up between competitors who do not even share the same language but a common experience. Participants going on foreign holidays making beelines to see their new friends and, finally, a network of family and friends developing.
The other outstanding surprise was the comradeship which developed between organ recipients of all nations. A runner would stop and help anyone who fell thereby losing their own chance of success in the race. And the person coming in last often got the loudest cheers from the spectators. Unusual in normal athletic competition at any level.
Transplantation: Today, Transplant games consist of Winter and Summer games. What are key disciplines and how many participants are present?
PROFESSOR DR. MAURICE SLAPAK: In the Summer Games, held every 2 years, there is a wide variety of events which include most track and field events together with swimming in all its components. Racquet sports and golf are popular, in addition to selected sports which are practiced in the host country; archery, canoeing and sailing are not uncommon; between 1500 and 2000 competitors take part.
In the Winter Games all forms of alpine and Nordic skiing. We stay away from ski jumping. A major feature in these games is the Nicholas cup in which transplanted children from many countries are housed in a camp for 1 week and learn compete and get to know each other in a spirit of great fun. It commemorates a 7-year-old boy called Nicholas Green who was killed in Italy and whose parents supported the donation of 7 organs to 7 Italian recipients.
Transplantation: What future goals do you see for Transplant Games?
PROFESSOR DR. MAURICE SLAPAK: At present, we have 76 countries in the World Transplant Games Federation. I would look to expanding into the countries that are not yet active members and more controversially. I would also include kidney transplant recipients who lost their organ and are on some form of dialysis.
Transplantation: You have also been one of the founding members of the European Society of Organ Transplantation and the society’s first Vice-President. Can you share some insights into the founding of ESOT?
PROFESSOR DR. MAURICE SLAPAK: It all began in Boston in 1952. For some 15 years, The USA was clearly the leading country and Boston was the Mecca for young aspiring transplant surgeons and physicians. But during that period major contributions were also made by individuals from European countries. Names that spring to mind amongst many others are Roy Calne, Peter Morris, Brian Woodruff, Ruggero Ceppellini, Jean Dausset, and Jon Van Rood. For that reason, together with Hans Brynger of Gothenburg, we felt that the European contribution was worth its own society and a founding group of 8 members came together for the first meeting in Zürich in 1976.
Transplantation: A Fulbright stipend brought you to Harvard in 1968. What work did you do while being in Boston?
PROFESSOR DR. MAURICE SLAPAK: I joined the Harvard unit of Boston City Hospital in 1968 under the directorship of Bill McDermott. I was invited to take over the liver section and inherited Judah Folkman’s laboratories and office space who had accepted the position as chair of surgery at Boston Children’s Hospital. It was a very happy 3 years. I was one of only 4 surgical consultants and we each had some 5 to 6 research fellows to look after and produce good research papers so that the NIH research grants would continue. Rotating clinical involvement was in the Harvard unit where we each took a month supervising and operating with residents.
A memory which stands out is that of a patient who Dr. Frances Moore asked me to treat at the Peter Brent Brigham Hospital. The patient was in acute liver failure and we explored treatment by cross circulating him with a baboon.
Transplantation: You have also supported health care in emerging countries and have been an advisor to the Presidents of Kenya and Mongolia. Could you share some details of the work that you have done in those countries?
PROFESSOR DR. MAURICE SLAPAK: I had met the President of Kenya professionally in London and was asked to advise on the running of the Kenyatta National Hospital. This led to a personal relationship which has lasted to this day. I was brought up in Kenya from the age of 7 to 18 and have a great affection for that country and its people. Thus, I was pleased to train Dr. Ernest Kioko trained at the Wessex transplant unit for 1 year before he went back to Nairobi. Ernest was an excellent trainee and became one of the leading transplantation figures in Kenya for the next 30 years. Prof. Harry Lee at our unit in Wessex had been able to train 2 nephrologists who went back to Nairobi and looked after patients transplanted in Kenya and elsewhere.
Transplantation: You are a member of Britain’s most prestigious sports and private clubs including The All England Lawn Tennis and Croquet Club, Wimbledon, The Queens, Hurlingham and Athaneum Club in London and the Hawks Club in Cambridge. How do you spend your time when you are not thinking about Transplant Games?
PROFESSOR DR. MAURICE SLAPAK: To slow senile dementia and creaking joints, I continue a long-time passion for sport and I am fortunate in being able still to play tennis and take part in (sometimes painful) physical activities most days.