The Medawar Prize 2012, Dr David Sutherland

THE MEDAWAR PRIZE The Transplantation Society (TTS) has awarded the Medawar Prize at each of its biennial congresses since 1990. Designed to honor Sir Peter Medawar, the first president of our society, for his seminal contributions to transplantation, it is considered to be among the outstanding world honors for scientific achievement. The prize recognizes individuals who have made a significant scientific discovery or contribution to our field, or who have a lifetime body of work in immunobiology and experimental or clinical transplantation. Winner of the Nobel Prize in 1960 for pioneering the field of transplantation biology, Peter Brian Medawar began his career as a young Oxford zoologist. Too tall for military service in World War II, he was firmly suggested by the War Wounds Committee of the British Medical Research Council, concerned about the treatment of burned airmen, that he be “of service to the medical community” and examine why skin could not be accepted between individuals. Initially working with a plastic surgeon in the Burns Unit of the Glasgow Royal Infirmary, Medawar returned to Oxford where he confirmed in rabbits his clinical observations that genetic differences between donor and host evoke differential immune responses and that the subject would reject a “second set” of skin grafts from the same donor in an accelerated fashion, in brief, that immunologic host mechanisms mediate graft behavior. Later, with colleagues Rupert E. Billingham and Leslie Brent, he showed in mice that introduction of specific foreign cells during fetal or neonatal life could prevent subsequent skin graft rejection. The subject of “immunologic tolerance” continues to captivate investigators to this day. Medawar was a lifelong contributor and supporter of our emerging field, and his scientific, literary, and philosophical influences remain as guiding lights for those who have followed. TTS is fortunate to have a great wealth of scientific talent among its membership. This year, the Medawar Prize Committee received nominations for many qualified individuals who have greatly contributed to transplantation. The winner of the 2012 Medawar Prize recipient is Dr. David E.R. Sutherland. It is a great honor to announce Dr. David Sutherland as the 2012 recipient of the Medawar Prize of TTS. I met Dr. Sutherland for the first time in the fall of 1975. I visited the University of Minnesota (UM) to learn more about islet transplantation. On my punctual arrival at this office, he was nowhere to be found and his secretary apologized for not being able to offer me a seat in his office, but I did have a glance at this place and quite frankly I have never seen anything close to an office like this. The four walls of his office were stacked from the floor to the ceiling with reprints and books. Even the window was partially covered. Of course, the desk was full of all kinds of paperwork and I had the feeling if I just made the wrong move the entire construction would collapse. David arrived approximately 45 min late in scrubs and a white coat, which was two sizes too large for him. He said “we talk while we are walking” and continued at a rapid pace to various places in the hospital, frequently interrupted by pages and residents. He also talked so fast that, given I had just arrived in the United States from Germany, I could only understand fragments of what he was talking about. Finally, after several hours, he took me to the faculty club where we had a nice and reasonably quiet lunch. From this point on, David and I stayed in frequent contact and over the years became friends. When I started the pancreas transplant program at the University of Wisconsin in Madison, I did expect that some competition would evolve. But just the opposite occurred. Dave and I communicated on difficult cases, exchanged the latest news, and took care of each other’s patients. David’s professional life is described here in some detail, but I have to emphasize his great willingness to share and help everybody in the field to get better results. David is unselfish and personally started the International Pancreas Transplant Registry, calling out around the world in order not to miss any cases. His presentation style became legendary. He usually showed dozens of slides more than his time allowed and compensated for it by speaking extremely fast. Over the years, my wife and I always looked forward to seeing David and his wife Vanesa at meetings. The Sutherlands were a very special couple and David’s enduring and special care for Vanesa touched many of us. I think Carl Groth said it best a few years ago when he introduced Dr. Sutherland at a meeting when he said “David Sutherland is not only a great surgeon but the best human being I know in our field.”Dr David Sutherland - Medawar Prize recipient 2012Dr. Sutherland started his research career in immunology under the mentorship of Dr. Robert A. Good at the UM Medical School and graduated in 1966. He then interned at West Virginia University, served 2 years in the U.S. Army, and completed his surgery residency and a transplant fellowship at the UM. In 1976, he joined the university faculty, where he has spent his entire career. He received his Ph.D. in 1977, was promoted to professor of surgery in 1984, and was head of the Division of Transplantation from 1994 to 2009. He founded and has been the director of the UM Diabetes Institute for Immunology and Transplantation since 1994, and is holder of the Dobbs Diabetes Research Chair. As a transplant surgeon, Dr. Sutherland has trained numerous surgeons heading organ and pancreatic transplant programs worldwide and has overseen more than 2000 pancreas transplants at the UM. He performed the world’s first clinical islet transplant in 1974 alongside his mentor Dr. John Najarian, and he developed minimally invasive β-cell replacement (BCR) therapy as an alternative to insulin therapy or pancreas transplantation to treat diabetes. He also initiated the preservation of β-cell mass by islet autotransplantation at the time of total pancreatectomy for chronic pancreatitis in 1977, with nearly 435 such procedures completed to date. In 1980, Dr. Sutherland founded the International Pancreas Transplant Registry. Dr. Sutherland has been of service for national and international organizations and societies, including serving as president of TTS (2002–2004), the International Pancreas and Islet Transplant Association (1996–1997), the Cell Transplant Society (1994–1996), and the American Society of Transplant Surgeons (1990–1991). He has also served on the editorial boards of many journals, including Cell Transplantation, Diabetes, Transplantation, Transplantation Proceedings, and Pancreas. He has been editor-in-chief for Clinical Transplantation since January 2007. Dr. Sutherland’s principal scientific achievement is his being the major force in the development of BCR for the treatment of diabetes. In the early 1970s, he began work on islet transplantation to make BCR minimally invasive. He recognized the long-term challenges and simultaneously refined techniques of pancreas transplantation to avoid problems that plagued earlier series. In the late 1970s, he resurrected clinical pancreas transplantation at the UM, while persevering with islet research. In 1977, Dr. Sutherland showed that islet autografts could preserve insulin secretion after total pancreatectomy for chronic pancreatitis, establishing a new treatment of the disease, now proved metabolically durable. The first successful series of single-donor islet allografts occurred under his direction. In 1980, he established the International Pancreas and Islet Transplant Registry, one of the most useful registries, publishing outcome analyses for nearly 30 years. The unique contributions that Dr. Sutherland has made to pancreas transplantation include the first living-donor segmental graft (1979), aiming not simply to solve organ shortage but to decrease the rejection rate in the pre–calcineurin inhibitor era. He also first described isletitis with selective β-cell destruction and recurrence of diabetes in pancreas isografts (identical-twin donors) and allografts (1984), a key observation in establishing the disease as autoimmune. Finally, more than anyone in the field, he emphasized pancreas transplant alone in nonuremic patients whose diabetes was more severe than the adverse effects of immunosuppression, comprising a quarter of the first 1000 cases at the UM, a series now of greater than 2000 transplants. The field could not have developed as it did without Dr. Sutherland’s passion and numerous contributions. The Transplantation Society Recognition Awards 2012 Dr Jeremy R Chapman Past President The Transplantation Society International Headquarters1255 University Street Suite 605 Montreal, QC H3B 3V9 Canada. Email: [email protected] RECOGNITION AWARDS TTS recognizes several individuals at each of the international congresses of the society who have made a major international impact in transplantation. The 2012 TTS Recognition Awards were presented at the XXIII International Congress of TTS in Berlin, August 2012, to the following individuals: TTS• ASTURIAS AWARD FOR INTERNATIONAL COOPERATION Luc Noël, France This award reflects the award given jointly to TTS and the Spanish “Organización Nacional de Trasplantes,” which recognized the international cooperation between the TTS and Organización Nacional de Trasplantes: the “Prince of Asturias Award for International Cooperation” is a highly esteemed international award, included among its previous winners are Nelson Mandela, Al Gore, the Bill and Melinda Gates Foundation, Helmut Kohl, Lula da Silva, the World Health Organization (WHO), Mikhail Gorbachev, and other equally prestigious contributors to the goal of international cooperation. Established in 1980, these awards aim to contribute to encouraging and promoting the scientific, cultural, and humanistic values that form part of humankind’s universal heritage. TTS has sought to reflect this perspective through the TTS–Asturias Award for international cooperation to the individual or organization that, in the opinion of the council, has fostered international cooperation in transplantation the most in the preceding 2 years. The award was given to Dr. Luc Noël for his work with the WHO. Luc Noël received his medical degree from the University of Grenoble and specialized in clinical biology, hematology, and blood transfusion in Lyon and Paris. As a consultant, he contributed to the reorganization of the French Transfusion Service, culminating in a single national blood transfusion organization, the Etablissement Français du Sang. In particular, he contributed to setting up the system of vigilance and surveillance of adverse reactions known as haemovigilance and to optimizing the clinical use of blood components. In 1999, he was appointed by the WHO as coordinator of Blood Transfusion Safety. In 2004, he led the Clinical Procedures Unit, responsible “for ensuring efficacy, safety and equity in the provision of clinical procedures in surgery, anaesthetics, obstetrics and orthopaedics, particularly at the district hospital level.” The Clinical Procedures Unit is also “in charge of promoting the appropriate effective and safe use of cell, tissue and organ transplantation, including surveillance of risks, in particular in xenotransplantation trials.” A global meeting organized in Madrid in November 2003 led to Resolution WHA57.18 of the 57th World Health Assembly (WHA) in May 2004, which revived the topic of transplantation at the WHO. In the last 5 years, the WHO, with the help of member states and civil society, including the scientific and professional community, has worked at raising awareness of access, safety, and ethical issues in cell, tissue, and organ transplantation. This work culminated in Resolution WHA63.22 endorsing the Revised WHO guiding principles on human organ and tissue transplantation.TTS• ASTURIAS AWARD FOR INTERNATIONAL COOPERATION: Luc NoËl, SwitzerlandTTS• GENZYME AWARD FOR EDUCATION AND TRAINING IN TRANSPLANTATION: Gabriel Danovitch, United StatesGabriel Danovitch received his medical degree from St Bartholomew’s Hospital of the University of London. He completed his residency training in London and Beersheba, Israel, and his nephrology training at Albert Einstein College of Medicine in New York. He served on the faculty at Albert Einstein and then directed the nephrology unit at Soroka Hospital in Israel. He is a distinguished professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles and is the medical director of its renowned Kidney Transplant Program. He has published more than 180 original articles and 50 book chapters. He has mentored a generation of transplant physicians and leads one of the longest functioning kidney transplant medicine fellowships in the United States. Dr. Danovitch is an authority on clinical transplant care, transplant ethics, and public policy. He has served on the board of the American Society of Transplantation and the United Network for Organ Donation and is current chair of its International Relations Committee. He is a founding member of the Custodian Group of the Declaration of Istanbul on Organ Trafficking and Transplant Tourism. His textbook, the Handbook of Kidney Transplantation, in its fifth edition and translated into four languages, has become required reading for those entering the field.TTS• GENZYME AWARD FOR INNOVATION IN SURGERY AND TECHNOLOGY: Pierre A. Clavien, SwitzerlandPierre A. Clavien is a professor and the chair of the Department of Surgery at the University Hospital Zurich in Switzerland. After his stint in the Swiss Board of Surgery, he moved to Toronto, Canada, to complete a Ph.D. program in organ preservation, followed by a clinical fellowship in hepatobiliary surgery and liver transplantation. He then moved to Duke University, Durham, NC, where he initially led the liver transplantation and hepatobiliary program and, subsequently, the Division of Transplantation and obtained the rank of full professor. After 9 years at Duke University, he returned to Switzerland as chair of the Department of Surgery at the University Hospital of Zurich. His areas of research include organ preservation, liver ischemia-reperfusion injury and regeneration, and pathogenesis of cancer, as well as outcome research. He has received many competitive grants and awards, including the Otto Naegeli Award and the prestigious UEGW research award.TTS• NOVARTIS AWARD FOR OUTSTANDING CONTRIBUTION TO THE EVIDENCE BASE FOR TRANSPLANTATION: Yves Vanrenterghem, BelgiumProf. Dr. Yves Vanrenterghem received his M.D. degree in 1973 from the Catholic University of Leuven, Belgium, where he is currently a professor of medicine and the chairman of the Department of Nephrology and Renal Transplantation at the University Hospital. During the last three decades, he has been involved in the examination of novel immunosuppressive compounds in renal transplantation in numerous randomized controlled trials. He has designed and advised on many phase III and phase IV clinical studies in drug development, as principal investigator or chair. He has authored more than 340 scientific publications and book chapters, including 80 papers on clinical trials. His clinical expertise focuses on (novel) immunosuppression, minimization protocols, and complications after renal transplantation. He has been president of the Eurotransplant International Foundation for more than a decade, for which he received an honorary award from King Albert II of Belgium. He has been a European representative on the Council of TTS and has been or is still editorial board member of several scientific journals, including Transplantation; Transplantation Proceedings; the American Journal of Transplantation; the American Journal of Kidney Diseases; Nephrology, and Transplantation; and Transplant NOVARTIS AWARD FOR OUTSTANDING is a transplant surgeon at the University Hospital in since and a professor of transplant surgery at University, since His research in renal transplantation. He has had an in a large of clinical for the and the He contributed to the European in Renal Transplantation, published in 2000 and He has also in the work for the published in the November of the American Journal of Dr. was an of the American Journal of Transplantation from 2003 to and is a member of the editorial boards of Transplantation, Clinical Transplantation, and Transplant He is also a member of the Committee of the Organ Transplantation Research He has been the president of the European Society of Organ Transplantation and was the director of medical of TTS and is TTS AWARD FOR OUTSTANDING IN United is a professor of immunology in the Department of University of where the Transplantation Research Immunology research focuses on at the and immune and between the immune system and is a of the of Medical and received a Royal Society Award for research professional include a of and was president of TTS and is an of Dr. his M.D. and Ph.D. from the University of He to the University of Wisconsin in a fellowship in the Research and his residency In 1980, he joined the faculty of the University of Wisconsin under the of and from Dr. in through he was the chairman of the Division of Organ He was the of Surgery in Dr. is a member of the American the American Society of Transplant Surgeons and the International Society for Organ He is an honorary member of the European He is a president of the and the International Society for Organ He was a member of the of Health Surgery, and from 1994 to In he was appointed to a on the U.S. Committee on Organ Transplantation; he served as chair. In Dr. received the American Society of Transplantation and in he was awarded the in in Transplantation Surgery AWARD FOR OUTSTANDING IN United AWARD FOR IN is a surgeon, director of the Transplant and in Surgery at the University Health and professor in the Division of Surgery and Institute of and at the University of He completed his medical training at the University of in He trained in surgery, surgery, and surgery at the University of Toronto, followed by fellowship training at University and the University of London for surgery and transplantation, He joined the faculty at the University of in 1994 and was promoted to full professor in He served as chair of the Division of Surgery at the University of from to and was the holder of the in He is a in the for Medicine at the University Health His in the pioneering of transplantation in to a career in transplantation. He leads a research that is published in the His research is in injury to transplantation. His current work the of and therapy to and to for transplantation.TTS• AWARD FOR Nelson United Nelson is the clinical director for Transplant and in the Division at the also the of professor of medicine at Medical the of and in the transplant are key for Dr. has presented on these at many and international meetings. is the current president of the Transplant of as well as a member for the American Society of Transplantation and the Society of was the and chair for the three International Transplant Dr. on the editorial boards for Transplantation and Transplantation and has authored and numerous and chapters. the International on the of in Organ Transplantation, published in Transplantation, and is a meeting to the AWARD FOR IN TRANSPLANTATION: is the of the Kidney since of the transplantation in he is also the director of the for Organ Transplantation, the national organ in Dr. is an of several journals, including the Journal of Kidney and Transplantation, and Clinical Transplantation, and Nephrology He is a member of national and international and has served on the of the International Society for Organ Donation and the Society of Organ Transplantation the of Istanbul Custodian and the Madrid on Organ Dr. to expertise in organ and transplantation the and as a representative of on the Council organ transplantation to successful program in these His areas of include and establishing and procedures for organ and transplantation, treatment of chronic kidney renal replacement and The Awards were presented during the Transplantation Congress to young who had to the and received the from an international of awards were made through an from United United United

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