The Medawar Prize was designed to honor Sir Peter Medawar for his contributions to transplantation research. His most notable work was the discovery of acquired immune tolerance, for which he was awarded the Nobel Prize in 1960 shared with Sir Frank Macfarlane Burnet. Jeremy was born in the United Kingdom, studied medicine in Cambridge and London, and received his specialist nephrology training in Oxford. In 1985, he embarked on his doctorate degree under the mentorship of two Australians, Sir Peter Morris and Dr Alan Ting. During his Fellowship years, he has made several seminal observations. Jeremy demonstrated that cyclosporin toxicity in deceased donor allograft was reversible 90 d after transplantation, despite very high starting doses at 17.5 mg/kg.1 His interest and clinical cautions for calcineurin inhibitor nephrotoxicity has continued throughout his career. Using dithiothreitol (DTT) reduction in CDC crossmatches, he was able to distinguish and eliminate false-positive crossmatch results from IgM subclass autoantibodies which allowed successful transplantation. The addition of DTT to this assay is still standard practice in tissue typing laboratories worldwide.2 Jeremy migrated to Sydney, Australia with Clare, his wife and Robert, his eldest son in 1987, a move facilitated by his very good friend, Richard Allen, a young Australian transplant surgeon at the time who also trained in Oxford. Together, they established the first successful simultaneous kidney and pancreas transplantation program in Australia in 1987 (Figure 1) that became the National Pancreas Transplant Unit in 1992.FIGURE 1.: The three pioneers of the kidney pancreas transplant program at Westmead 1987. Left: Richard Allen, Middle: Stephen Deane, Right: Jeremy Chapman.At the time, Westmead Hospital, in the western suburbs of Sydney was still in its infancy. As a true visionary and a progressive thinker, Jeremy saw both opportunities and needs of population growth in Western Sydney, particularly in disadvantaged and immigrant populations. He has always had an acumen at “joining the dots” and could effortlessly weave the threads of workable policy through the complexities of politics and bureaucracies into a larger tapestry of meaning. Together with his team in his adopted country, he has not only established one of the largest transplantation programs in Australia from scratch but has also developed a group of hugely successful clinical and laboratory researchers and created robust ethical governance structures for clinical transplantation at the national and international levels. Jeremy’s research has directly impacted on the international transplantation community. It has derived from translational work in the areas of kidney, kidney pancreas and other solid organ transplantation, and provided a platform for evidence-based clinical practice and policy. This in turn has resulted in improved care and outcomes for patients across a very broad range of clinical problems, improving transplantation access for sensitized patients, reducing the risk of acute rejection using novel immunosuppression, and understanding the risk and improving the care of patients with cancer after transplantation.3 He established the Australian Donor Bone Marrow Registry and was one of the founding members of the World Donor Bone Marrow Association. This Registry has established a network of potential bone marrow donors around the globe to provide a cure for patients with terminal hematologic malignancies. Together with Brian Nankivell, Richard Allen, and Philip O’Connell, he has defined the natural history of chronic allograft nephropathy which has revolutionized the thinking as to the cause of chronic allograft deterioration and improved standards of clinical practice in transplantation.4 Jeremy is a strong advocate for equitable and ethical transplantation practices. He was the President of The Transplantation Society (2008–2010) and was responsible in the organization of multiple major global scientific meetings, educational platforms, and research development in transplantation. He developed a global role for The Transplantation Society and worked with the World Health Organisation to improve access to ethical organ donation and transplantation services globally and through the establishment of the Declaration of Istanbul on Organ Trafficking and Transplant Tourism. With this instrument, international consensus on the ethical treatment of organ donors was established providing a pathway for transplantation to be offered to the developing world by defining unethical treatment of donors and fostering safe and accountable practices for transplantation.5 In the course of this work, he met with political and religious leaders and visited countries around the world that have undertaken organ transplantation with a major focus on preventing human organ trafficking and commercialism. Stopping unethical practices including the use of executed prisoners as organ donors across the world has been at the center of his work. He was a member of the Expert Advisory Panel of the World Health Organisation on organ donation and transplantation and has worked with emerging economies to develop legal and clinical systems to support transplantation in countries with emerging economies including Fiji, Mongolia, Pakistan, Sri Lanka, Myanmar, Vietnam, and Colombia. Finally, as his mentee, I am forever proud and honored to have worked with Jeremy for >2 decades since having been an intern resident at Westmead. Jeremy has the extraordinary ability to turn gray into blue skies, allow agency and empowerment of his team and with that approach unleashing an extraordinary synergistic effect of positive energy. Jeremy has constantly reminded us that the sky of possibilities for improving the field of transplantation is vast and endless. He has provided a platform for all of us to excel, develop, and strive for what we do best: research, clinical care, and capacity development. Over the many years, he has taught us three things: kindness, generosity, and service, the key elements to being an outstanding clinician scientist in transplantation. Together with the entire Westmead transplant team, I cannot think of anyone more worthy of this award.
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Apr 1, 2024
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