A New Kidney from Moscow

As head of the special surgical team at New York Hospital, Dr. William Stubenbord routinely performs more than a hundred kidney transplants a year. But there was something special about one of his cases last week. The kidney that he transplanted into a 32-year-old man had been taken from a Russian teenager fatally injured only 48 hours earlier in a Moscow traffic accident.

The successful surgery was an encouraging example of medical detente that began last summer when Dr. Albert Rubin, director of the hospital's Rogosin Kidney Center, visited Moscow's Institute of Transplantation, which is headed by the prominent surgeon Dr. Valery Shumakov. The two doctors agreed that exchanging information and technology could lead to improved care for kidney patients in both countries. Shumakov volunteered, as a first step, to send a kidney to American doctors. (There are more kidneys available in the U.S.S.R. than in the U.S. because there are fewer legal obstacles to obtaining organs and fewer patients awaiting transplants.) In the U.S., at least half of the 32,000 patients on kidney machines are hoping for donor organs. Said Shumakov: "An exchange of kidneys to me is something more practical and tangible than an exchange of delegations."

Packed in Ice. Shortly after the youth died, Shumakov transplanted one of the boy's kidneys into a Soviet recipient, and directed his team to prepare the other for shipment to New York. Carefully preserved in sterile solution and wrapped in plastic bags and ice, the kidney was placed aboard a regularly scheduled Moscow-New York Aeroflot jet, while Shumakov sent word to U.S. doctors via a Soviet friend in New York that a kidney was on the way. Rushed by ambulance from the airport, the kidney was bathed in nutrient-rich fluid, then "typed" so that doctors could choose a recipient whose body tissue matched it. Out of the clinic's list of some 200 potential candidates, the doctors picked Puerto Rican-born Jose Serrano, a former construction worker with incurably diseased kidneys who was alive only because he was hooked three times weekly, four hours a day, to a dialysis machine.

Odds that a transplanted cadaveric kidney will "take" are usually no better than 50%, yet only twelve hours after surgery, Serrano's new organ had already produced some five liters (5 1/4 quarts) of urine and seemed to be functioning well. By week's end Serrano was joking that despite his Muscovite kidney, "I don't speak Russian yet." His doctors were equally elated. Rubin, for one, envisioned a day when organs are regularly shuttled across the seas to fulfill needs wherever they exist. Said he: "What better way to bring the world together than through medicine."

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