René Küss
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René Küss (3 May 1913 – 2006) was a French
urologist Urology (from Greek οὖρον ''ouron'' "urine" and ''-logia'' "study of"), also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary system and the reproductive organs. Org ...
and
transplant surgeon A transplant surgeon is a surgeon who performs organ transplants. Among the many organs that can be transplanted are: kidneys, livers, hearts, lungs, the pancreas, the intestine (especially the small intestine), and recently, faces, tracheal (wind ...
who made pioneering contributions in renal tract surgery and
kidney transplantation Kidney transplant or renal transplant is the organ transplant of a kidney into a patient with end-stage kidney disease (ESRD). Kidney transplant is typically classified as deceased-donor (formerly known as cadaveric) or living-donor transplantat ...
with the establishment of transplant programs. At a time of unavoidable
transplant rejection Transplant rejection occurs when transplanted tissue is rejected by the recipient's immune system, which destroys the transplanted tissue. Transplant rejection can be lessened by determining the molecular similitude between donor and recipien ...
, he was involved in two particularly historic transplant operations. The first was a human-to-human extraperitoneal
kidney transplant Kidney transplant or renal transplant is the organ transplant of a kidney into a patient with end-stage kidney disease (ESRD). Kidney transplant is typically classified as deceased-donor (formerly known as cadaveric) or living-donor transplantat ...
procedure in 1951 and later a pig-to-human kidney transplant in 1966, both of which ended in abrupt rejection. He later introduced kidney transplantation schedules involving at first
irradiation Irradiation is the process by which an object is exposed to radiation. An irradiator is a device used to expose an object to radiation, most often gamma radiation, for a variety of purposes. Irradiators may be used for sterilizing medical and p ...
, later
immunosuppressants Immunosuppressive drugs, also known as immunosuppressive agents, immunosuppressants and antirejection medications, are drugs that inhibit or prevent the activity of the immune system. Classification Immunosuppressive drugs can be classified ...
, living-related and unrelated
donors A donor in general is a person, organization or government which donates something voluntarily. The term is usually used to represent a form of pure altruism, but is sometimes used when the payment for a service is recognized by all parties as rep ...
and later
organs In a multicellular organism, an organ is a collection of tissues joined in a structural unit to serve a common function. In the hierarchy of life, an organ lies between tissue and an organ system. Tissues are formed from same type cells to a ...
from deceased donors. Küss established several urology departments at the Paris hospitals, became General Secretary and between 1952 and 1985 took up presidency for the
Société Internationale d'Urologie Groupe Lactalis S.A. (doing business as Lactalis) is a French multinational dairy products corporation, owned by the Besnier family and based in Laval, Mayenne, France. The company's former name was Besnier S.A. Lactalis is the largest dairy pr ...
. In 1971, he founded the first scientific society devoted to
transplantation medicine Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be trans ...
in Europe,
La Société Francaise de Transplantation LA most frequently refers to Los Angeles, the second most populous city in the United States of America. La, LA, or L.A. may also refer to: Arts and entertainment Music *La (musical note), or A, the sixth note *"L.A.", a song by Elliott Smit ...
. Although they worked separately, the simultaneous efforts of Küss and
nephrologist Nephrology is a specialty for both adult internal medicine and pediatric medicine that concerns the study of the kidneys, specifically normal kidney function (renal physiology) and kidney disease (renal pathophysiology), the preservation of kid ...
Jean Hamburger Jean Hamburger (15 July 1909 – 1 February 1992) was a French physician, surgeon and essayist. He is particularly known for his contribution to nephrology, and for having performed the first renal transplantation in France in 1952. Biograph ...
are felt by transplant peers including
Nobel prize winner Nobel often refers to: *Nobel Prize, awarded annually since 1901, from the bequest of Swedish inventor Alfred Nobel *The Nobel family, a prominent Swedish and Russian family; see there for the list of people with the surname Nobel may also refe ...
Joseph Murray Joseph Edward Murray (April 1, 1919 – November 26, 2012) was an American plastic surgeon who is known as the "father of transplantation" for major milestones in the field of transplantation, including performing the first successful human ki ...
, to have "largely been forgotten", and that they have not been given "full credit for their work internationally".


Early life and education

Küss was born on 3 May 1913 into a Protestant family from
Alsace Alsace (, ; ) is a cultural region and a territorial collectivity in the Grand Est administrative region of northeastern France, on the west bank of the upper Rhine, next to Germany and Switzerland. In January 2021, it had a population of 1,9 ...
. He grew up with firm morals and responsibilities, being the son of a distinguished and wealthy surgeon who was at one time president of the French Academy of Surgery. Küss's grandfather's brother was
Émile Küss Émile Küss (1 February 1815 – 1 March 1871) was a French physician who, with Charles-Emmanuel Sédillot, performed the first recorded biopsy on a tumour. He later entered politics in Strasbourg, became mayor, and played a significant role in ...
, a physician at the
University of Strasbourg The University of Strasbourg (, Unistra) is a public research university located in Strasbourg, France, with over 52,000 students and 3,300 researchers. Founded in the 16th century by Johannes Sturm, it was a center of intellectual life during ...
and the last
mayor of Strasbourg Prior to the French Revolution, Strasbourg was led by an Ammestre. List of Mayors of Strasbourg since the French Revolution {, class="wikitable" !# !Name ! colspan="2" , In office !Party !Ref. , - !1 , Baron Philippe-Frédéric de Dietric ...
prior to its annexation by Germany. His father headed the general surgical department at Paris's
Hôpital de la Charité Hôpital de la Charité (, "Charity Hospital") was a hospital in Paris founded by the Brothers Hospitallers of St. John of God in the 17th century. In 1935, it was closed and demolished to make way for the new faculty of medicine. Located at 45, ...
, later known as the Hopital Broussais. Küss recalled first attending an operating theatre with his father at the age of seven. He had two brothers and two sisters and his family spent time travelling between their homes by the seaside, on the mountains and in Paris, in pursuit of sports and arts. He was educated at the
University of Paris The University of Paris (), known Metonymy, metonymically as the Sorbonne (), was the leading university in Paris, France, from 1150 to 1970, except for 1793–1806 during the French Revolution. Emerging around 1150 as a corporation associated wit ...
School of Medicine and held an appointment as a surgical resident at the
Hôpital Broca The Hôpital Broca is a hospital of the Public Assistance - Paris Hospitals (AP-HP) located at 54-56 rue Pascal in the 13th arrondissement of Paris, specializing in clinical gerontology Gerontology ( ) is the study of the social, culture, ...
, Paris, under the chief of service,
Robert Proust Robert Emile Sigismond Léon Proust (24 May 1873 – 29 May 1935) was a French urologist and gynaecologist and the younger brother of the writer Marcel Proust. Both brothers had an early education at the Lycée Condorcet, with Robert Proust ...
, the brother of the author
Marcel Proust Valentin Louis Georges Eugène Marcel Proust ( ; ; 10 July 1871 – 18 November 1922) was a French novelist, literary critic, and essayist who wrote the novel (in French – translated in English as ''Remembrance of Things Past'' and more r ...
.


Second World War

Küss left his early medical training at the age of 26 to enlist in the
French army The French Army, officially known as the Land Army (, , ), is the principal Army, land warfare force of France, and the largest component of the French Armed Forces; it is responsible to the Government of France, alongside the French Navy, Fren ...
during the Second World War, and subsequently became physician to the
French navy The French Navy (, , ), informally (, ), is the Navy, maritime arm of the French Armed Forces and one of the four military service branches of History of France, France. It is among the largest and most powerful List of navies, naval forces i ...
. He survived the
attack on Mers-el-Kébir The attack on Mers-el-Kébir (Battle of Mers-el-Kébir) on 3 July 1940, during the Second World War, was a British naval attack on French Navy ships at the naval base at Mers El Kébir, near Oran, on the coast of French Algeria. The attack was ...
as physician-in-chief on the destroyer ''
Mogador Essaouira ( ; ), known until the 1960s as Mogador (, or ), is a port city in the western Morocco, Moroccan region of Marrakesh-Safi, on the Atlantic Ocean, Atlantic coast. It has 77,966 inhabitants as of 2014. The foundation of the city of Essao ...
'', which was bombed and eventually sunk off the coast of North Africa in the
Scuttling of the French fleet in Toulon The scuttling of the French fleet at Toulon was orchestrated by Vichy France on 27 November 1942 to prevent Nazi German forces from seizing it. After the Allied invasion of North Africa, the Germans invaded the territory administered by Vichy ...
. On one occasion, he jumped overboard into the "oil-slick-covered sea to rescue crewmen". He received the War Cross with Palm for his war efforts. He headed General
George Patton George Smith Patton Jr. (11 November 1885 – 21 December 1945) was a general in the United States Army who commanded the Seventh Army in the Mediterranean Theater of World War II, then the Third Army in France and Germany after the Alli ...
's 3rd American army's surgical team across France and into Germany and by "alternately manipulating scalpels and grenades", contributed to the efforts of the
French resistance The French Resistance ( ) was a collection of groups that fought the German military administration in occupied France during World War II, Nazi occupation and the Collaboration with Nazi Germany and Fascist Italy#France, collaborationist Vic ...
to liberate Paris. The whole time, he operated on both American and German injured soldiers.


Surgical career

After the war, Küss made innovations in urology at the Cochin Hospital, in particular in urinary drainage and vascular reconstructions in transplant cases. This came at a time when urology and vascular surgery were expanding as specialities with new diagnostics, particularly the introduction of
intravenous pyelography Pyelogram (or pyelography or urography) is a form of imaging of the renal pelvis and ureter. Types include: * Intravenous pyelogram – In which a contrast solution is introduced through a vein into the circulatory system. * Retrograde pyelogra ...
in 1937 and David Hume's vascular developments on
joining Join may refer to: * Join (law), to include additional counts or additional defendants on an indictment *In mathematics: ** Join (mathematics), a least upper bound of sets orders in lattice theory ** Join (topology), an operation combining two topo ...
arteries. He developed the Boari-Küss method for elongating the
ureter The ureters are tubes composed of smooth muscle that transport urine from the kidneys to the urinary bladder. In an adult human, the ureters typically measure 20 to 30 centimeters in length and about 3 to 4 millimeters in diameter. They are lin ...
and contributed to the elaboration of placing a donor kidney into the extraperitoneal space or
iliac fossa The iliac fossa is a large, smooth, concave surface on the internal surface of the Ilium (bone), ilium (part of the three fused bones making the hip bone). Structure The iliac fossa is bounded above by the iliac crest, and below by the Arcuate ...
, a technique that has continued into the 21st century. Two operations are particularly considered "historic" by contemporaries. Küss, together with Charles Dubost and Marceau Servelle, was involved in the first human-to-human extraperitoneal kidney transplant procedure on 12 January 1951. Another two surgeons, Oeconomos and Rougeulle, had previously assisted Küss with the laboratory experiments and were also present to assist. The procedure became known as the "Küss operation" owing to his chief role in it. Organs from four guillotined prisoners were used in four of the five kidney transplants. One kidney came from a living donor undergoing a kidney removal in a Matson procedure for
hydrocephalus Hydrocephalus is a condition in which cerebrospinal fluid (CSF) builds up within the brain, which can cause pressure to increase in the skull. Symptoms may vary according to age. Headaches and double vision are common. Elderly adults with n ...
, where a kidney would otherwise be discarded. All the grafts were rejected. At the time, it was not unusual to carry out the donor operation on the prison floor or in the autopsy room. In one interview, Küss "admitted that sometimes the surgeons had to wait ‘like vultures’ for the patient (donor) to die" and that even "one of the donor kidneys was procured from a living patient". Lack of immunosuppressants, poorly preserved donor kidneys, suboptimal state of recipients and lack of post-operative
intensive care Intensive care medicine, usually called critical care medicine, is a medical specialty that deals with seriously or critically ill patients who have, are at risk of, or are recovering from conditions that may be life-threatening. It includes p ...
, all contributed to poor initial results. By 1952, he was led to believe that America would have the best chance of success by performing the transplants on
identical twins Twins are two offspring produced by the same pregnancy.MedicineNet > Definition of Twin Last Editorial Review: 19 June 2000 Twins can be either ''monozygotic'' ('identical'), meaning that they develop from one zygote, which splits and forms two e ...
, which in 1954, they did. The second historic operation took place in 1966, by which time irradiation as an immunosuppressive and some basic immunosuppressants,
6-mercaptopurine Mercaptopurine (6-MP), sold under the brand name Purinethol among others, is a medication used for cancer and autoimmune diseases. Specifically it is used to treat acute lymphocytic leukemia (ALL), acute promyelocytic leukemia (APL), Crohn's d ...
and
cortisone Cortisone is a pregnene (21-carbon) steroid hormone. It is a naturally-occurring corticosteroid metabolite that is also used as a pharmaceutical prodrug. Cortisol is converted by the action of the enzyme corticosteroid 11-beta-dehydrogenase ...
, had been introduced. After reading results of experimental studies by
Roy Calne Sir Roy Yorke Calne (30 December 1930 – 6 January 2024) was a British surgeon and pioneer in organ transplantation. He was part of the team that performed the first liver transplantation operation in Europe in 1968, the world's first liver, ...
, Küss had already administered 6-mercaptopurine six years earlier. Küss, along with assistant surgeon Jacque Poisson, performed a cross-species procedure, transplanting two pig kidneys into one patient. The graft was unsuccessful instantly and the patient shortly died. Küss later described this as a painful experience. Transplant surgeon and friend of Küss,
Thomas Starzl Thomas Earl Starzl (March 11, 1926 – March 4, 2017) was an American physician, researcher, and expert on organ transplants. He performed the first human liver transplants, and has often been referred to as "the father of modern transplantation ...
recalled that Küss "was left with a lifetime xenophobia for xenografts" following this experience. Results remained poor and by 1967, the failure rate amongst the 101 transplants he performed was around 50%. Küss established several urology departments at the Paris hospitals, became General Secretary and in 1952 took up presidency for the Société Internationale d'Urologie, where he remained so until 1985. In order to advance the urology clinic at the University
Pitié-Salpêtrière Hospital Pitié-Salpêtrière University Hospital (, ) is a charitable hospital in the 13th arrondissement of Paris. It is part of the AP-HP Sorbonne University Hospital Group and a teaching hospital of Sorbonne University. History The Salpêtrière ...
, in 1972, he resigned from private practice. He simultaneously established the La Société Francaise de Transplantation. Retiring from clinical duties in 1985, he later, in the 1990s, served as President of the French National Academy of Medicine. He was awarded Commander of the French Legion of Honor and in 2002 became a Medawar Laureate of the Transplantation Society.


Personal

Among Küss's girlfriends was a
showgirl A showgirl is a female performer in a theatrical revue who wears an exotic and revealing costume and in some shows may appear topless. Showgirls are usually dancers, sometimes performing as chorus girls, burlesque dancers or fan dancers, and ...
from the well known
Le Lido Le Lido is a musical theatre venue located on the Champs-Élysées in Paris, France. It opened in 1946 at 78 Avenue des Champs-Élysées and moved to its current location in 1977. Until its purchase by Accor in 2021, it was known for its exoti ...
. He eventually married in his mid-forties, at the request of his father, and went on to have four children. Küss was a
racecar driver Auto racing (also known as car racing, motor racing, or automobile racing) is a motorsport involving the racing of automobiles for competition. In North America, the term is commonly used to describe all forms of automobile sport including non ...
and competed in the
Monte Carlo Rally The Monte Carlo Rally or Rallye Monte-Carlo (officially Rallye Automobile Monte-Carlo) is a rallying event organized each year by the Automobile Club de Monaco. From its inception in 1911 by Albert I, Prince of Monaco, Prince Albert I, the rally ...
. There was one incident in 1954 when he lay comatose for some days following an accident during a race at the
Tour de France Automobile Tour de France Automobile was a sports car race held on roads around France regularly (mostly annually) between 1899 and 1986. History The first edition in 1899 was won by René de Knyff driving a Panhard et Levassor at 30 mph (50&nbs ...
. He was brought up with a deep interest in art and acquainted with eminent Parisian artists of the time including
Raoul Dufy Raoul Dufy (; 3 June 1877 – 23 March 1953) was a French painter associated with the Fauvist movement. He gained recognition for his vibrant and decorative style, which became popular in various forms, such as textile designs, and public build ...
. He added to his father's antique and contemporary art collections, subsequently exhibiting them near his second home at the seaside village of
Honfleur Honfleur () is a commune in the Calvados department in northwestern France. It is located on the southern bank of the estuary of the Seine across from Le Havre and very close to the exit of the Pont de Normandie. The people that inhabit Hon ...
. His art collection was auctioned at
Christie's Christie's is a British auction house founded in 1766 by James Christie (auctioneer), James Christie. Its main premises are on King Street, St James's in London, and it has additional salerooms in New York, Paris, Hong Kong, Milan, Geneva, Shan ...
in Paris in 2006, following his death. One part of his collection that including work by
Henri Toulouse-Lautrec Count, ''Comte'' Henri Marie Raymond de Toulouse-Lautrec-Monfa (24 November 1864 – 9 September 1901), known as Toulouse-Lautrec (), was a French painter, printmaker, draughtsman, caricaturist, and illustrator whose immersion in the colour ...
,
Pierre-Auguste Renoir Pierre-Auguste Renoir (; ; 25 February 1841 – 3 December 1919) was a French people, French artist who was a leading painter in the development of the Impressionism, Impressionist style. As a celebrator of beauty and especially femininity, fe ...
and
Claude Monet Oscar-Claude Monet (, ; ; 14 November 1840 – 5 December 1926) was a French painter and founder of Impressionism painting who is seen as a key precursor to modernism, especially in his attempts to paint nature as he perceived it. During his ...
, sold for more than four million Euros.


Death and legacy

Küss died in 2006. An engraved memorial marble lies at the hospital of Pitié‐Salpêtrière where he established a school of urology. In 2014, The Board of the European Association Urology (EAU) Section of Transplantation Urology (ESTU) awarded the first René Küss Prize for original work on renal transplantation. It was presented by Küss's daughter, Ms. Sophie Morello-Küss. Although they worked separately, the simultaneous efforts of Küss and nephrologist Jean Hamburger are felt by transplant peers including Nobel Prize winner Joseph Murray, to have "largely been forgotten", and they not to have been given "full credit for their work internationally".


Selected publications


''Surgery of the Ureter''
Springer-Verlag Springer Science+Business Media, commonly known as Springer, is a German multinational publishing company of books, e-books and peer-reviewed journals in science, humanities, technical and medical (STM) publishing. Originally founded in 1842 in ...
, 1975, * In addition, he co-authored * ''Histoire Illustre ́e de L’Urologie'' * ''An Illustrated History of Organ Transplantation.''


References


External links


La Société Francaise de Transplantation
{{DEFAULTSORT:Kuss, Rene 1913 births 2006 deaths French medical writers French urologists French Protestants French transplant surgeons Xenotransplantation History of transplant surgery 20th-century French surgeons Commanders of the Legion of Honour Grand Officers of the Ordre national du Mérite