Rescue by Radiation

One morning in mid-March. Mrs. Gladys Lowman, 31, wife of a roofer in Franklin, Ohio, awoke with what she called a bad stomachache. Drugs brought no relief all day. An orange-sized lump soon began to bloat her abdomen. When her doctor ordered emergency surgery. Dr. Walter A. Reese at Ohio's Middletown Hospital operated at once. He found a hemorrhage in a kidney that had apparently been displaced from birth. Swiftly, because the patient otherwise would have bled to death, Surgeon Reese removed the kidney. Despite massive transfusions, Mrs. Lowman lost so much blood during the operation that she "died" on the table. After her heart had stopped for four minutes, artificial respiration and more transfusions were needed to bring it back to life. Already qualifying as a rare case, Mrs. Lowman then became a rare phenomenon twice over.

In the operation's aftermath came the shocking discovery that Mrs. Lowman, mother of two children, had been born with only one kidney. Now she had none--and no human can stay alive without a kidney. Surgeon Reese's next swift decision was to transfer her to Boston's Peter Bent Brigham Hospital, where he knew that a medical team could keep her alive temporarily with an artificial kidney. Armco Steel Corp., which employs two of her brothers, flew Mrs. Lowman and Dr. Reese to Boston at once in a company DC-3.

New Theory. Then, with the mechanical kidney in frequent operation, began a three-week preparation at Brigham for one of the most radical operations ever attempted: transplanting a kidney between persons who lack common genes. In recent years, a Brigham team had succeeded six times (and failed once) in kidney transplants--but only between identical twins. Of 17 attempted transplants between unrelated persons, none worked; antibodies in the recipients' blood destroyed the "foreign" tissue. The operations worked for the twins because of the rare match between the patients' genes: instead of being destroyed by antibodies, the transplanted kidneys "took."

In the desperate case of Mrs. Lowman, doctors operated for the first time on a new theory. Since antibodies are born in blood cells produced in the bone marrow, it might be possible to curb them by destroying the marrow itself. No mechanism would then remain to reject a transplanted tissue. New bone marrow, from several donors to minimize antibody hostility, could then be injected intravenously.

Taking Over. For three hours under an X-ray machine. Mrs. Lowman was subjected to massive radiation that killed all her bone marrow. Her white blood corpuscle count fell from the normal 5,000 per cubic centimeter to zero. Then a kidney from a four-year-old girl (whose treatment for hydrocephalus required kidney removal) was transplanted to Mrs. Lowman. The Boston surgeons attached it to the femoral arteries and veins below the groin in her right thigh. She received a dozen marrow transfusions before and during the operation, mainly from her brothers. With her count of disease-fighting white corpuscles still at only 250 per cc., she has been kept ever since in the near-sterility of an operating room.

Last week the Brigham physicians were still faced with the task of offsetting the radiation destruction of both white and red corpuscles, still listed Mrs. Lowman's condition as ''critical." They were unwilling to comment in any way on their achievement. But it was a fortnight after the operation, and the patient was still alive. Moreover, use of the artificial kidney was gradually being eased, and there were hopeful signs that the transplanted kidney was beginning to function.

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