Rex Boake is a pioneer of kidney transplantation in North America.
A chilly January day in Edmonton was the setting for Alberta's first organ transplant--a kidney transplanted by the late William Lakey, urologist at the University of Alberta Hospital. This breakthrough happened 50 years ago, marking the beginning of the province's renal transplant program. Last month, many in Alberta's health care community gathered to celebrate this special birthday.
On January 26, 2017, representatives from the University of Alberta Hospital, Alberta Health Services, Faculty of Medicine & Dentistry, Alberta Transplant Institute and University Hospital Foundation came together at McMullen Gallery to recognize the work of the talented specialists that turned the renal transplant program into the success it is today.
Paving the way to save lives
Rex Boake, FoMD alumnus and one of the pioneers of kidney transplantation in Alberta along with Lakey, was a guest of honour at the ceremony. Boake gave guests a peek into the early years of these surgical breakthroughs.
"In 1967 when Bill [Lakey] performed the first kidney transplant I was in UCLA in Los Angeles, learning how to do kidney transplants," remembers Boake. "At that time there were probably 50 kidney transplants done in North America so far, and that was the year that immunosuppression drugs were introduced. That was the first time when there was hope that kidneys could last without being rejected."
Lakey's first transplant patient lived for two months, and overall it was difficult to predict higher survival rates at that time. Organ rejection was a very common occurrence. "We didn't have access to the anti-rejection medication or the tissue typing and blood matching for donors and recipients there is today," explains Boake.
According to Boake, the introduction of immunosuppressive drugs led to a rapid increase in transplants. In 1967 alone, UCLA performed 50 transplants--equal to the number attempted altogether across all of North America previously. At the same time, the U of A and a few other centres in the U.S. were beginning to perform these surgeries as well.
Boake returned to the U of A in 1969 to work in the renal program with Lakey. Together, they performed hundreds of transplants--by the time they retired, they had completed more than 800 procedures in total.
For Boake, the limited resources and technology were a significant challenge during those years of discovery. When they were informed of a potential viable organ for transplant that could become available soon, they had to get ready to rush out to get that organ at any moment.
"When we'd get that phone call, everything would stop. That meant you had to sit and be available to go instantly," says Boake. "Now put that in perspective. There were no iPhones at that time. No cell phones... there weren't even pagers! That's how far back it was."
Taking part in this trip down Memory Lane was also Ray Ulan, another guest of honour for his groundbreaking work in dialysis. He has retired from practice as well, with the University of Alberta Hospital's dialysis unit named after him. Ulan and Boake spent much of their career together, making the event a true friends' reunion for them.
Living proof
Freda Ainley attended the event with reasons to celebrate as well, as a recipient of a kidney transplant that was performed by Boake in the 1970s.
"I wasn't doing well on dialysis but I was scared. I hadn't seen anyone with a successful transplant," says Ainley. "My 12 year-old daughter, Gillian, looked at me and said, 'You're not like anyone else. Just because it didn't work for them, doesn't mean it won't work for you.'"
Ainley's daughter was right. This April, it will be 45 years since Ainley's transplant, making hers one of the longest-surviving donor kidneys in the world.
Rex Boake with her former patient Freda Ainley.
"The survival rate wasn't as good as it could be, and certainly nothing like it is now," says Boake, emphasizing the great achievement of Ainley's successful transplant. "I think it's remarkable. Only someone as sweet as Freda could get along with that kidney for so long!" he jokes.
Kidney transplants, today
Dedicated physicians continue to follow the footsteps of Lakey, Boake and Ulan, changing people's lives and providing second chances to patients with the contribution of organ donors. More than 2,800 kidney transplants have been performed to date at the University of Alberta Hospital. Today, 95 per cent of patients in the local renal transplant program survive the first five years. Half of the successful kidney transplants from a living donor are still functioning at 20 years.
"I think the Faculty of Medicine & Dentistry and the University of Alberta Hospital should be long recognized as one of the main centres of kidney transplantation," concludes Boake.
The renal transplant program is supported by the University Hospital Foundation, and the FoMD's Alberta Transplant Institute (ATI). Kidney transplantation is only one of the many areas covered in ATI's quest for quality innovation, treatment and research.
Currently, 170 patients in the program are waiting for a viable kidney to get a transplant.
If you want to learn more about becoming an organ donor, you can find information here.
Meet our partners in innovation
The Alberta Transplant Institute is one of the leading centres of its kind in Western Canada. Through ATI, the U of A facilitates transplant quality improvement, conducts drug trials with innovative immunosuppressive protocols, and trains many of the world's transplant physicians and surgeons.
Alberta Health Services delivers health support and services for more than four million adults and children living in Alberta. Its mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans.
The University Hospital Foundation has supported the transplant program since the UAH first pioneered transplants in 1967. Community donors have given more than $5 million to change and save lives by helping advance transplant patient care at the UAH, and research that has allowed the program to contribute to the international standard of transplant care.