Exeter's first kidney transplant

To see a surgeon attach the blood vessels to a donor kidney, the clamps released and urine start to drip from the yet to be attached uretha, is almost magical. It was such a procedure that was first performed in Exeter during April 1968, when a 35 year old man was given the kidney of a 15 year old girl.

Albert James Gale a sheet metal worker, was married, with two small children–he had suffered kidney failure since 1956, and had been extremely ill for the previous two months before the transplant. At that time, kidney dialysis was in its infancy, and many patients died, due to a shortage of dialysis machines. The first dialysis machine at Exeter was introduced by Dr Harry Hall in 1967, based in Whipton.

Albert Gale was chosen for Exeter’s first attempt at a transplant, and had been on dialysis in preparation. On 4 April, a kidney became available and the team of nine doctors and theatre nurses, led by Cyril Shaldon, the consultant surgeon, transplanted a kidney from the donor to Gale in a procedure that lasted two hours. The patient was moved to an isolation unit in the Royal Devon and Exeter Hospital in Southernhay, to recover.

The news breaks

News of the transplant appeared in the Express and Echo two days later, although the names of the surgeon, patient and donor were withheld. The first bulletin was “entirely satisfactory so far". The surgeon was quoted as saying “operations of this kind are performed regularly in the country… if similar circumstances arise we will perform another operation in Exeter.” This was unduly modest, as this only was the fifth or sixth transplant in the UK.

The first kidney transplant in the United Kingdom was in 1965, and although a few other hospitals had performed kidney transplants by 1968, this procedure was still unusual. The National Organ Matching and Distribution Service wasn’t established until 1972, and the Organ Donation Register was still 26 years away.

The donor

Exeter’s organ donor was named, along with the patient on 8 April, when the Express and Echo ran the story “Exeter’s First Kidney Transplant–Dying girl makes operation possible”. Fifteen year old Elizabeth Costigan from Beacon Heath was on the pillion of her boyfriend Martin Kelly’s motor-cycle when it was in collision with a van at the junction of Market Street and Fore Street. Elizabeth received critical head injuries and was taken to hospital. Her father told the Echo that she had said to him just two weeks before, after she had seen a program about heart transplantation, “You know, Dad, if ever I was dying after an accident and any part of my body could save a life I would gladly give it.” When it was established that Elizabeth's injuries were fatal, the painful task of obtaing consent to use a kidney was decided. Her father went on “When the hospital asked us about removing the kidney, we agreed because we knew it would be our daughter’s wish… She was that kind of kid. She would do anything to help anyone.” Nowadays, the name of the donor would not be known to the patient, nor the public.

Albert Gale was interviewed by the Echo at the end of April, when he was allowed home during the day “It is marvellous, I have not felt so well since 1956… I was always feeling tired, lifeless, with sickness and headaches. When I was asked whether I would consent to have the operation, I said I would leave it up to the doctors.” He hoped that he would soon be able to return to work.

Kidney care in Devon

The kidney unit at Exeter has expanded to the point where they treat 400 patients on hospital dialysis, and 80 with home dialysis. They stopped performing kidney transplants in 1997, after about 600, and all transplant patients are now sent to Plymouth and Bristol. In 2010, on the 40th anniversary celebration of the kidney unit, patient Chris Phillipson, who started dialysis in 1973 and was transplanted in 1979 cut a cake with Dr Harry Hall to celebrate the event. He told the press “It’s both strange and lovely to be back and see all these old faces.”

Sources: The Express and Echo, "The Royal Devon and Exeter Hospital 1741-2006" by Andrew Knox and Christopher Gardner-Thorpe and http://units.renal.org/?c=exeter.