BSc, MBChB, MD (Leeds)
Pioneer of Kidney Dialysis
During the night of 30th September 1956, the first dialysis was performed by Frank Parsons at Leeds General Infirmary. This marked the opening of the first artificial kidney unit in the UK, the fore-runner of all British renal services. There has since been a continuous history of dialysis at the LGI, resulting in what was described in an editorial in the Quarterly Journal of Medicine* as the longest, largest and best documented series in the world.
Frank Parsons graduated from Leeds in 1943 and, as a surgical trainee, worked in Professor Leslie Pyrah’s MRC Surgical Metabolism Unit at the LGI. Leslie Pyrah was a distinguished Leeds graduate (MBChB 1924). In 1953 Parsons went to Chicago to continue his research. Whilst in Chicago, it was suggested to him that it might be interesting to visit John Merrill at the Peter Bent Brigham hospital. Merrill and his colleagues had used dialysis to treat wounded soldiers with acute renal failure in Korea, and were now introducing it in a civilian teaching hospital. Parsons’ brief visit to Boston eventually lasted three months and he returned to Leeds convinced of the value of dialysis. He and Pyrah persuaded the Infirmary Board of Governors to purchase a Brigham-Kolff dialysis machine for the (then) enormous sum of £5,500.
When the machine was halfway across the Atlantic, Parsons was summoned to the Medical Research Council, to be greeted with “Our advisors say there is no place for an artificial kidney in British medicine...” In a two-hour meeting Parsons recounted his experience of dialysis in Boston. The parting words from Sir Harold Himsworth were “Parsons, try it but remember that the country is against you...”
There followed a period when the LGI (and later, the Hammersmith Hospital) provided the entire dialysis service from acute renal failure in the UK, the patients usually being transferred to Leeds by train. Whilst Parsons might have been happiest using his mechanical skills to maintain and modify the prototype dialysis machines, he would not have been so successful without many other players. The medical input for these very sick individuals was provided by a series of Leeds graduates working in Professor Ronald Tunbridge’s medical department. One of them, Christopher Blagg (MBChB 1954), would later join Belding Scribner in Seattle to pioneer long-term dialysis for end-stage renal failure. Surgical trainees had to make and then insert the cannulas allowing access to the circulation for dialysis. There were so few working in clinical nephrology that international connections were strong, and Parsons was instrumental in creating with European colleagues what became the European Dialysis and Transplant Association. Leeds provided training in dialysis for many nephrologists, but it took several years for dialysis to be generally accepted in the UK and for most teaching hospitals to install a machine. Parsons and colleagues developed modifications of dialysis and the ‘Leeds’ machine was still in occasional use until about 1980.
In retrospect, the persistence and endeavour of the Leeds group that lead to the acceptance of dialysis treatment was helped by a ‘fortunate’ coincidence. At that time, acute renal failure due to pregnancy or septic abortion was a significant problem. Word quickly spread of the remarkable survival figures at Leeds of this otherwise fatal obstetric complication. These young women provided dramatic proof that in acute renal failure, if the patient could be kept alive by renal support of the kidneys with dialysis until the kidneys regenerated, full recovery would follow.
Fortunately, obstetric renal failure is now vanishingly rare in the UK. The skill and commitment of the nursing, technical and medical staff at Leeds resulted in a patient survival approaching 100%, an unimaginable outcome for the modern elderly patients with multi-system failure.
The pioneering efforts of Parsons and his colleagues in Leeds deserve prominence in the history of British medicine. They entered largely uncharted waters. Formidable technical and medical problems arose, were identified and solved de novo. They worked in a medical atmosphere that, outside Leeds, was generally unsympathetic, conservative or uninterested. Nevertheless, what an American pioneer called “the roaring 50s” must have been very exciting. Parsons’ mentor, Leslie Pyrah, went on to perform arguably the world’s first cadaveric renal transplant at the LGI with “Fred” Raper (MBChB Leeds 1937), but that is another fascinating story of achievement in a very different world from the NHS of today.
*Cameron, J S. Quart J Med 1990; 74: 1-2
Author: John H Turney retired Consultant Renal Physician, The General Infirmary at Leeds, now studying for a PhD in medical history at the Wellcome Unit, Centre for the History of Science, Technology and Medicine, Manchester University.
The School of Medicine is grateful to the author and to the Editor of Medicine Matters (The School of Medicine Alumni magazine) for permission to reproduce the text from Issue 24, Summer 2006.
