Robert McCabe , Jr; Kidney Donation Specialist,

The clock was ticking. The kidneys of a 14-year-old girl who had died in a Virginia hospital had been removed from her body with her parents’ consent, in the hope that the organs might extend the life of others. But with only a rudimentary computer network available to help them in 1979, officials at the hospital, Norfolk General, could not find a suitable recipient for one of the kidneys, and they knew they had only 72 hours, at most, to do so.

So they reached out to St. Luke’s Hospital Center in New York, where Dr. Robert E. McCabe Jr., an early specialist in kidney transplantation, was head of the renal preservation laboratory. He began scouring the New York area for potential recipients but found none. Nationally, not a single compatible recipient could be found among 6,000 or so people awaiting a transplant. He called colleagues in Italy and Kuwait. No luck.

Then, cutting through the cold war tensions of the time, he called the Soviet Embassy in Washington and told them to relay a message to Dr. Valery I. Shumakov, a prominent transplant surgeon he had met that April: a kidney was on the way — please find it a home.

The girl, who had suffered head trauma in a traffic accident, had died shortly after noon on a Tuesday in June. The next day, working with the embassy, St. Luke’s put the kidney on a Soviet Aeroflot flight to Moscow out of Kennedy International Airport (after fending off security officials who wanted to check the storage container for explosives). The kidney arrived safely, and Dr. Shumakov soon reported that he had successfully transplanted the organ into a 36-year-old man that Thursday afternoon. (The girl’s other kidney was implanted in a 51-year-old man in Newark.)

In the worlds of medicine and international politics, Dr. McCabe’s determination to link donors with recipients had brought about a rare collaboration with the Soviets. But for Dr. McCabe, who died at 88 on Aug. 29, the episode underscored the shortcomings in the American system of kidney donations.

“We should have been able to use those kidneys at home, but we weren’t organized adequately in New York City to use them all locally, or in the States themselves,” he said in a recent interview on the Web site of the American Society of Transplant Surgeons, of which he was a founding member. “We shouldn’t have had to go that far.”

The first successful kidney transplant was conducted in 1954, and the procedure was rapidly adopted around the world. But by the late 1970s, hospitals faced challenges in preserving an organ during the out-of-body interim and in matching donors with recipients.

Dr. McCabe, who performed transplants at St. Luke’s, taught himself to become a specialist in organ preservation using cold storage as well as a machine developed by the transplant surgeon Dr. Folkert O. Belzer. The process, known as machine perfusion, uses a blend of fluids to simulate a kidney’s natural function until the kidney is transplanted. Dr. McCabe helped refine the blend.

But even with these preservation efforts, a kidney could be kept functional outside the body only for up to 72 hours.

The 1979 episode was not the first kidney transplant between the United States and the Soviet Union — there had been at least two others — but it exemplified the improvisational nature of transplant surgery and organ donation at the time.

Dr. McCabe’s photograph, showing him helping to push free a police car that had become stuck in the mud while transporting a kidney into Manhattan, had once appeared in The Daily News in New York. On another occasion he delivered a kidney to Italy using a perfusion machine, the fluid inside frothing as the car in which he transported it through Rome bumped along cobblestone streets.

“In those days it was a free-for-all,” said Dr. Thomas G. Peters, a surgeon who is the historian for the transplant society. “This was cowboy time.”

But the New York-to-Moscow episode had a positive effect in generating publicity for the transplant program — the account appeared on the front page of The New York Times — and that in turn led to a noticeable rise in kidney donations.

Over time, databases of kidney donors and recipients became more sophisticated, as did preservation methods, enabling transplants to be accomplished far more speedily. In 1984, to prevent entrepreneurs from profiting from transplantation and hospitals from moving wealthy patients to the top of the waiting list, Congress passed the National Organ Transplant Act, which outlawed the sale of organs and established a regulatory framework for donations.

Dr. McCabe said that one benefit of tighter regulations was a more efficient process of determining when an organ donor was dead so that the organ could be harvested.

“We’d hear about a donor on Tuesday or Wednesday, and we couldn’t get the neurologist to declare brain death,” he said in the online interview. “They were some of the skeptics too, frankly, and they would not declare brain death until Friday afternoon at 5, when they were tired of caring for the patient and wanted us to take over. So we would be busy every weekend.”

Robert Emmet McCabe Jr. was born on Feb. 20, 1925, in Charleston, W.Va. His father, Robert, was a lawyer, and his mother, the former Margaret Ward, was a homemaker. He graduated from Williams College in 1948 and received his medical degree in 1953 from Cornell University Medical College in Manhattan. He served as a surgeon in the Army from 1955 to 1957.

Dr. McCabe died of cancer at his home in Londonderry, Vt., his family said. Survivors include four daughters, Elsie Smith, Coco McCabe, Rue Sherwood and Kay McCabe; a son, Robert Emmet III; and nine grandchildren. His wife of 58 years, the former Katherine Robinson, died last year.Story Source: