In the 1960s, Belgian transplant surgeon Guy-Alexandre risked professional rebuke by removing kidneys from brain-dead patients whose hearts were still beating, greatly improving organ survival rates while also reducing the risk of death. He died on February 14th, the person who performed the surgery that called into question the very definition of the term. His home in Brussels. He was 89 years old.
His son, Xavier, confirmed his death.
In June 1963, Dr. Alexandre was only 29 years old and had just completed a one-year fellowship at Harvard Medical School, when a young patient was driven to the hospital where he worked in Leuven, Belgium. Although she sustained trauma to her head in a car accident and underwent extensive brain surgery, her doctors declared her brain dead, although her heart continued to beat.
He knew that there was a patient in another part of the hospital suffering from kidney failure. He had assisted with kidney transplants at Harvard University and understood that as soon as his heart stopped beating, the organ began to lose its viability.
Dr. Alexandre pulled aside the chief surgeon, Jean Morel, to make his point. Brain death is death, he said. Even if the machine keeps the heart beating for long periods of time, it has no hope of resuscitating the patient.
Although his argument went against centuries-old assumptions about the boundaries between life and death, Dr. Morel was persuaded.
They removed the young patient’s kidney, cut off the ventilator, and completed the transplant within minutes. The recipient lived another 87 days. That in itself was an important accomplishment, considering that the science of organ transplantation was still in its infancy at the time.
Over the next two years, Dr. Alexandre and Dr. Morell quietly performed several more kidney transplants using the same procedure. Finally, at a medical conference in London in 1965, Dr. Alexandre presented what he had been doing.
“There has never been, and there will never be, a question of removing organs from a dying patient who has an ‘unreasonable chance of recovery or regaining consciousness,'” he told the rally. “The problem is harvesting organs from the dead. The important thing is that I do not accept the cessation of heartbeat as a sign of death.”
Others in the audience, including some prominent figures in the organ transplant field, said they were less convinced.
Roy Calne, a pioneering British transplant surgeon, told the conference: “Changing the way deaths are diagnosed to make transplants easier would bring the whole operation into disrepute.” (Dr. Karun passed away in January.)
Dr. Alexandre took a firm stand and laid out a set of criteria for determining whether a patient was brain dead. In addition to a traumatic brain injury, the patient must have dilated pupils, low blood pressure, no reflexes, no ability to breathe without a machine, and no signs of brain activity.
Within a few years, Dr. Karun and others began to agree with Dr. Alexander’s claims. In 1968, a Harvard University task force, a group of medical experts, declared that irreversible coma should be understood as equivalent to death, whether or not the heart continues to beat. , which largely adopted Dr. Alexander’s criteria.
Dr. Alexandre’s views are now widely shared in the medical community, and it is common practice to remove organs from brain-dead patients.
“The greatness of Alexander’s foresight was that he was able to see through the insignificance of a beating heart,” says organ donation activist and journalist Robert Berman. Contributed to Tablet Magazine in 2019.
Guy-Pierre Jean-Alexandre was born on July 4, 1934 in Uccle, a suburb of Brussels, Belgium. His father, Pierre, was a government administrator, his mother, Marthe (Moulin) Alexandre, a personal assistant.
He entered the University of Leuven in 1952 to study medicine. Even after he finished his studies in 1959, he remained at the university to train as a transplant surgeon.
He married Eliane Mogens in 1958, but she died in October. In addition to his son, Dr. Alexandre’s survivors include his daughters Anne, Chantal, Brigitte, and Pascal; 17 grandchildren. and 13 great-grandchildren.
By the late 1950s, the field of transplant surgery was rapidly evolving. Among the major research centers was Peter Bent Brigham Hospital in Boston (now part of Brigham and Women’s Hospital), one of his teaching facilities at Harvard University, where the first kidney transplant was performed in 1954. I got it.
Dr. Alexander arrived at the Brigham in 1962, which coincided by several weeks with Dr. Calun, who was completing his own fellowship.Both worked for Joseph E. Murray, and in 1990 Murray Nobel Prize in Physiology or Medicine with research in transplant surgery.
Dr. Alexandre noticed that Dr. Murray would turn off the ventilator and wait until the heart had stopped beating before removing organs from brain-dead patients. This met the traditional definition of death, but it placed a huge strain on the organs.
“They considered the brain-dead patient alive, but they had no hesitation in turning off the ventilator to stop the heartbeat before removing the kidney,” Dr. Alexandre said. Berman in a Tablet article. “In addition to ‘killing’ the patient, they were giving the recipient a damaged kidney.”
Dr. Alexandre returned to the University of Leuven a year later and dedicated himself to putting his beliefs into practice.
He made several further contributions to the field of transplant surgery. In the early 1980s, he developed a method to remove certain antibodies from the kidneys, allowing them to be placed in the bodies of patients with otherwise incompatible blood types.
And in 1984, he performed one of the world’s first successful xenotransplants, transplanting an organ from one species to another. In this case, he transplanted a pig’s kidney into a baboon.
