Keith Reemtsma (1925-2000)

Abstract

Keith Reemtsma, a former president of The American Association for Thoracic Surgery, died on June 23, 2000. As chairman of the Department of Surgery of the Columbia University College of Physicians and Surgeons from 1971 to 1994, he had an overarching vision that surgery should be transformed from a predominantly destructive discipline of incision, excision, and amputation to a creative discipline of reconstruction, repair, replacement, and renewal. When he began his Columbia chairmanship, surgeons' work consisted predominantly of radical excision of malignant tumors and ulcerated stomachs. By the end of his 23-year tenure, the focus had almost completely shifted to transplantation for single organ failure, repair and reconstruction of diseased hearts and blood vessels, and highly targeted, function-preserving approaches to cancer. Underlying this transformation was a research and development infrastructure for which he was a pioneering architect. He proved that immunosuppressive medications prolong the survival of experimental heart transplants. His work solved a critical piece of the puzzle, complementing the demonstration of the surgical feasibility of heart transplantation by Richard Lower and Keith's close friend, Norman Shumway. For decades, he doggedly pursued the experimental feasibility of islet cell transplantation for diabetes. He was delighted to learn shortly before his death that a team in Edmonton had succeeded in successful islet transplantation in man. As chairman of the Department of Surgery at the University of Utah from 1966 to 1971, he assembled the team that ultimately produced the first artificial heart. He was the first to show that a mechanical circulatory assist device, the intra-aortic balloon pump, could serve as a mechanical bridge to heart transplantation. More recently, he founded the International Center for Health Outcomes and Innovation Research, a pioneering collaboration with Columbia's School of Public Health, to measure the outcomes of surgical intervention and understand the process of innovation in order to catalyze meaningful improvement in the quality of surgery and medicine at large. Perhaps Keith's most creative and certainly his most controversial work was in the field of cross-species transplantation. His early demonstration of the feasibility of chimpanzee-to-human kidney transplants, just before the era of hemodialysis, offered proof almost 40 years before the Human Genome Project of man's similarity to other species. Thomas Starzl, the pioneer of liver transplantation, has stated that “if xenotransplantation eventually works, no doubt the starting point will be traced to Keith Reemtsma.” His societal leadership positions included president of the Society of Clinical Surgery in 1976, president of the AATS, 1990-1991, and first vice president of the American Surgical Association in 1992. Keith's record of accomplishments in itself commands respect, even awe. But the truest measure of his life derives from his unique talent to inspire the continuation and extension of his own vision, creativity, energy, and joy in life to his family, friends, and colleagues. In recapitulating his own career when he was recognized for his life's work by the International Society for Heart and Lung Transplantation, Keith paraphrased the inscription in St Paul's Cathedral in London serving as an epitaph to its architect, Christopher Wren: “If you seek my monument, look around you.” In Keith's view, his successors represent his proudest legacy. He is survived by his wife, Judy, sons Dirk and Lance, and grandchildren Blake and Melissa.