NEW YORK — 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.
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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. The next day, working with the embassy, St. Luke's put the kidney on an Aeroflot flight to Moscow out of Kennedy International Airport (after fending off security officials who wanted to check the container for explosives). Shumakov soon reported that he had successfully transplanted the organ into a man that Thursday afternoon.
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 system of kidney donations.
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"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 website of the American Society of Transplant Surgeons, which he helped found. "We shouldn't have had to go that far."
The first successful kidney transplant was done in Boston in 1954. But even in the late 1970s, hospitals faced challenges in preserving organs and in matching them 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 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.
Often, improvisation was key. 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 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 bumped along Rome's cobblestone streets.
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"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."
Over time, databases of kidney donors and recipients became more sophisticated, as did preservation methods. In 1984, Congress passed the National Organ Transplant Act, which outlawed the sale of organs and established a regulatory framework for donations.
Dr. McCabe a graduate of Williams College who received his medical degree from Cornell University, died of cancer at his home in Londonderry, Vt. He leaves his four daughters, Elsie Smith, Coco McCabe, Rue Sherwood, and Kay McCabe; a son, Robert Emmet III; and nine grandchildren. His wife of 58 years, Katherine, died last year.