Pioneering Transplant Surgeon honours his profession with gift of education

Retired Clinical Professor Rex Boake recognized on National Philanthropy Day for investment in future of urology.

Kirsten Bauer - 23 November 2018

The Association of Fundraising Professionals (AFP) National Philanthropy Day Event takes place each year on November 15 to honour outstanding philanthropic achievements. For 2018, the Faculty of Medicine & Dentistry celebrates the generosity of the Rex Boake, '61 MD, trailblazing transplant surgeon, for the creation of the Dr. Rex Boake Studentship in Urology―a tribute to his profession and Division of Urology at the University of Alberta. The MD class of '65, and the School of Dentistry's Geoffrey Sperber, Paul Major, Kevin Lung, Rowland Haryett and Tom Stevenson were also recognized.

In 1953, Rex Boake left his home in Vermilion to attend the University of Alberta, taking the first steps toward a pioneering career in transplant surgery.

"I always knew I wanted to be a doctor. My father was a pharmacist and a lot of his friends were doctors, so I guess that's what kind of got me interested in taking medicine," Boake said.

A new and experimental medical field at the time, Boake was among the first cohort of residents in the urology residency program at the U of A, and has witnessed many advances throughout his career.

"I am probably the oldest person that's ever gone through that program," Boake said. "There were only about five before me and I was a bit older when I started."

Boake trained with J.O. Metcalfe, founder of the Division of Urology, whose son J.B. Metcalfe followed in his footsteps as a urologist. Boake was especially inspired by William (Bill) Lakey, the urologist known for performing the first kidney transplant at the University of Alberta Hospital.

Together, Lakey and Boake performed and coordinated hundreds of groundbreaking kidney transplants, helping to establish the U of A as a recognized centre of transplant excellence. Today, The U of A ranks sixth in the world in transplantation according to the Center for World University Rankings.

Below: Rex Boake, MD Class of '61

"I was trained in general urology, and in 1967 I went to the University of California in Los Angeles to learn about kidney transplants," Boake said. "I went down on an R.S. Mclaughlin Fellowship, which paid part of my expenses down there. That's why I wanted to do something similar for the Division of Urology."

Medical history in the making

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. Boake later became an expert in lithotripsy, a technology for treating kidney stones that has forever changed the urological field.

"One of the reasons was we were able to get a lithotripsy machine here is that people realized it was such a big advancement. And we were sending our patients who needed stone surgery to Vancouver."

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."

Boake has witnessed the evolution of his field, and he knows that with technological advancement we have only just began to understand what is possible in the field of urology.

"The majority of the changes occurred after I retired. Endoscopic surgery has changed everything," he said.

Investing in the future

A teacher in his own right, Boake is known to have taught countless students and residents including former Divisional Director Gerry Todd and 2018 Alumni Honour Award recipient Ronald Moore. According to Boake, the majority of what he taught his trainees is no longer practiced today, and he believes that the way forward is through educating the next generation.

The Dr. Rex Boake Studentship in Urology will hopefully provide students with the same type of opportunity that was offered to him early his career, but giving medical students a chance to work with urologists and hopefully spark the passion for urological surgery that has driven him throughout his career.

The reward, Boake says, is helping patients like Freda Ainley to live long and healthy lives., Aniley was a recipient of a kidney transplant performed by him in the 1970s. It has been more than 45 years since Ainley's transplant.

"She had a kidney transplant in 1972 and she is still doing very well. And she is probably the longest living kidney recipient from a posthumous donor in North America or the world. If there was a special patient that I ever did have, it would be her."

Rex Boake with former patient Freda Ainley.