Gabriel Richet (1916-2014).

Abstract

Raymond A. Ardaillou1 and Pierre M. Ronco2,3 for the Tenon community 1National Academy of Medicine, Paris, France; 2Renal Medicine, University Pierre and Marie Curie, Paris, France and 3Department of Nephrology and Dialysis and INSERM 1155, Tenon Hospital, Paris, France Correspondence: Pierre M. Ronco, University Pierre and Marie Curie, INSERM Unit 702, 4 rue de la Chine, Tenon Hospital, F-75020 Paris, France. E-mail: pierre.ronco@tnn.aphp.fr B orn in 1916 during the First World War, Gabriel Richet was the fourth of a lineage of famous academic medical doctors, all professors at the Faculte de Medecine in Paris, including his grandfather Charles Richet, who was awarded the Nobel Prize in 1913 for the discovery of anaphylaxis. Gabriel Richet was 23 years old at the outbreak of the Second World War. He had just passed the highly competitive residency examination when he was enlisted in the French army and actively participated in the military campaign. After being a prisoner of war in Germany for a short period, he was released and resumed his activities as a physician in the Paris hospital system. During the German occupation all members of the Richet family were actively engaged in the resistance movement. His father, Charles Richet, was deported by the occupational forces to the concentration camp Dachau, his brother Olivier to Dora, and his cousin Jacqueline Richet-Souchere to Ravensbruck, and his mother, Marthe, was jailed at Fresnes outside of Paris. Soon after the liberation of Paris in 1944, Gabriel Richet enrolled in the army under the high command of General Leclerc, whose army freed Strasbourg in November 1944. In the first months of 1945, fights continued in the area of Colmar in the south of Alsace where Gabriel Richet was active as a doctor of the French commandos. He was injured, received three military citations, and was decorated with the award of Chevalier de la Legion d’Honneur by General de Gaulle in April 1945. Demobilized from the army, Gabriel Richet joined the department of Louis Pasteur ValleryRadot, where he met Jean Hamburger, whom he followed to Necker Hospital to establish in 1950 the first French department of nephrology. He worked together with Jean Hamburger for 10 years, and both are considered to rank among the postwar rebuilders of French academic medicine. At Necker Hospital, Richet introduced treatment of acute kidney injury with the artificial kidney, which dramatically improved the prognosis of acute kidney failure associated with sepsis and crush syndrome. Together with the other members of the team of Jean Hamburger, Gabriel Richet was a leading investigator contributing to the worldwide reputation of the Necker ne phrology department. He was involved in the first allogenic kidney transplantation from a mother to her son, opening up exciting new therapeutic perspectives in living related transplantation. Introducing the percutaneous kidney biopsy pioneered by Claus Brun, Richet together with Hamburger contributed to the routine histological diagnosis of glomerular diseases, including the first studies by electron microscopy. The Necker team also demonstrated that most patients with advanced renal failure died from serious electrolyte changes rather than from retention of waste products such as urea. This led Richet together with Jean Hamburger and Jean Crosnier to develop the concept of renal intensive care aimed at correcting disorders of the major fluid, electrolyte, acid–base, and other metabolic functions, thereby markedly improving the prognosis of acute renal failure. In 1961, Gabriel Richet was appointed chief of nephrology at Tenon Hospital, at that time an inconspicuous city hospital in the middle of nowhere. He immediately set out to create a clinical and research nephrology center by recruiting a team that initially included Claude Amiel, Raymond Ardaillou, and Liliane Morel-Maroger. This team was then joined by Francoise Mignon, JeanDaniel Sraer, Pierre Verroust, Pierre Ronco, Eric Rondeau, and many others. This nephrology center was made possible by a new hospital wing supported by the French state through the Assistance Publique–Hopitaux de Paris and by INSERM (the French equivalent of the US National Institutes of Health), the University of Paris, the Association Claude Bernard, and the CNRS (National Center for Scientific Research), which also supported the research. Thereby Gabriel Richet succeeded in his goal of making the nephrology center at Tenon Hospital a place of national and international excellence for renal diseases as well as an intellectual haven, a foyer intellectuel, as he used to call it. The success could be measured by the large number of fellows and visiting faculty from countries all over the world who trained or did research in this multilingual and multicultural Tenon community, a virtual nephrological tower of Babel. Gabriel Richet provided a unique atmosphere of intellecGabriel Richet (1916–2014)