Samuel L. Kountz 1930-1981

Transplantation surgeon

At a Glance…

Helped Integrate Arkansas Medical School

Campaigned for Organ Donation

Known for Friendliness and Compassion

Sources

Dr. Samuel L. Kountz was one of the world’s most distinguished surgeons and a pioneer in the field of kidney transplantation. In 1961, while working with Dr. Roy Cohn at the Stanford University Medical Center, he performed the first successful transplant between humans who were not identical twins. Six years later, he and a team of researchers at the University of California, San Francisco, developed the prototype for the Belzer kidney perfusion machine, a device that can preserve kidneys for up to 50 hours from the time they are taken from a donor’s body. It is now standard equipment in hospitals and research laboratories around the world.

Among Kountz’s other contributions were the discovery that large doses of the steroid drug methylprednisolone could reverse acute rejection of a transplanted kidney, and that reimplantation—the implantation of a second donor kidney at the earliest indication that the first might be rejected—could mean the difference between death and survival for transplant patients. A tireless proponent of organ donation, he once performed a kidney transplant on live television, inspiring some 20,000 viewers to offer their kidneys to patients who needed them. In addition, his groundbreaking research in the area of tissue typing helped improve the results of kidney transplantation and led to the increased use of kidneys from unrelated donors. At the time of his death, he had personally performed some 500 kidney transplants, the most performed by any physician in the world at that time.

One of the first black students to graduate from the University of Arkansas Medical School in Little Rock, Kountz went on to complete his medical training at Stanford, where, while still a resident, he established a special organ transplant unit. He later became chief of the Kidney Transplant Service at the University of California, San Francisco. In 1972 he left California to accept the position of professor and chairperson of the department of surgery at the State University of New York’s Downstate Medical Center in Brooklyn. Driven by a deep social consciousness and a commitment to humanity, he spent the last five years of his career working to improve medical care in the black community. Thanks to Kountz’s efforts, Downstate’s organ transplant program quickly became one of the best in the country.

In an interview with B. Yuncker of the New York Post, given shortly after his arrival in Brooklyn, Kountz explained that he had refused to let racism—or any other obstacles—stand in the way of his career. “When I convinced myself in my teens that the same process that had created me had created everyone else, and that ’they’ had no corner on things …, except that they had economic advantages and better access to things, I suddenly realized that I had a certain control over my destiny,” he said. “It was a great revelation…. I cannot think of a single instance since 1952, when I have been denied anything because of being black.”

At a Glance…

Born Samuel Lee Kountz, October 20, 1930, in Lexa, AR; d ied December 23 ,1981, in Great Neck, NY; son of J. S. Kountz (a Baptist minister); married Grace Akin, 1958; children: Donald, Keith, Ellen. Education: Arkansas AM&N College, B.S., 1952; University of Arkansas, M.S., 1956, M.D., 1958.

Intern, Stanford Service, San Francisco General Hospital, 1958–59; assistant resident, department of surgery, Stanford University School of Medicine, 1959–62; Bank of America Giannini fellow, Hammersmith Hospital, London, 1962–63; Stanford University School of Medicine, senior resident, department of surgery, 1963–64, chief resident, 1964–65, instructor, department of surgery, 1965–66; visiting Fulbright professor, United Arab Republic, 1965–66; assistant professor, department of surgery, Stanford University School of Medicine, 1966–67; associate professor, department of surgery, University of California, San Francisco, School of Medicine, 1967–72, professor, 1972; professor and chairman, department of surgery, State University of New York Downstate Medical Center, Brooklyn, and chief of general surgery, Kings County Hospital Center, 1972–77.

Selected awards: Young Investigator’s Award, American College of Cardiology, 1964; Diplomate, American Board of Surgeons, 1966; Lederle Medical Faculty Award, 1967; Honorary Doctor of Humane Letters, University of California, San Francisco, 1970; Honorary Doctor of Laws, University of Arkansas, 1973; Honorary Doctor of Laws, Howard University, 1975.

Samuel Lee Kountz, the eldest son of a Baptist minister, was born in Lexa, Arkansas, in 1930. He first became interested in medicine at the age of eight, when he accompanied an injured friend to a local hospital for emergency treatment. He was so moved by the doctors’ ability to relieve suffering that he decided to become a physician. He completed his early education in Lexa, then spent three years at a Baptist boarding school established for youngsters considering the ministry. Although the school provided him with the discipline he needed, its academic program was weak, and he was forced to take remedial courses before gaining admission to the Agricultural, Mechanical and Normal College of Arkansas (now the University of Arkansas at Pine Bluff).

Kountz soon proved himself an able student, however, and graduated third in his class in 1952. His hopes and ambitions were clear. On his college application, submitted in July of 1948, he wrote that he planned to be “one of the best students that has ever attended AM&N College” and “one of the best doctors in the world in my day and time,” according to Claude H. Organ, Jr., in A Century of Black Surgeons: The U.S.A. Experience.

Helped Integrate Arkansas Medical School

During his senior year, Kountz happened to meet Senator J. William Fulbright, who had once been president of the University of Arkansas. Impressed by Kountz’s energy and enthusiasm, Fulbright asked him what he planned to do following graduation. Kountz told him that he hoped to attend a black medical school, where he could realize his lifelong dream of becoming a surgeon. Fulbright urged him to consider the medical school at the University of Arkansas, Little Rock, instead. Kountz applied but was rejected; he spent the next two years completing graduate work in chemistry at the university’s Fayetteville campus. Then, on the basis of his accomplishments, he was awarded a full medical scholarship, and in 1954 became one of the first black students to be admitted to the University of Arkansas Medical School.

Kountz completed a master’s degree in chemistry in 1956; two years later he received his M.D. He spent the next year as an intern with the highly competitive Stanford Service of San Francisco General Hospital, and, in 1959, he began his surgical training at the Stanford University School of Medicine. It was at Stanford that he studied under Dr. Roy Cohn, one of the pioneers in the field of organ transplantation, and decided to make transplant surgery his life’s work. He was still a resident in 1961, when he and Dr. Cohn made medical history by performing the first kidney transplant using a non-twin donor.

In 1962 Kountz was awarded a Bank of America Giannini Fellowship to study at the Postgraduate Medical School at Hammersmith Hospital in London. There he continued the research in transplantation and immunology. He returned to Stanford in 1963, and the following year was named chief resident in the department of surgery. During this period he discovered the effectiveness of methylprednisolone in reversing acute rejection of transplanted kidneys—an important revelation that led to widespread use of the drug in the management of kidney transplant patients. Methylprednisolone has since been used in the treatment of many other conditions.

Kountz’s groundbreaking research made headlines around the world. “When organs are transplanted from one dog to another, for instance, the recipient or host tends to treat the grafted or borrowed organ as a foreign invader, and it musters forces to reject it,” the New York Times explained in February of 1964. “Now in research at Stanford University and the Medical School of London, doctors have witnessed through microscopes the rejection mechanism operating at cell level…. After the first unsettled day, as the shock of the operation wears off, the blood supply to the kidney should become normal. Instead, there is a gradual but constant decline in the blood supply. From then on, the kidney dies from lack of blood-supplied oxygen. With dogs, Dr. Kountz and his associates have been able to watch through regular blood tests for the fall in the kidney blood supply…. At this point they can inject drugs that suppress the rejection mechanism.”

Nine months later, in November of 1964, Ebony proclaimed that Kountz’s new technique of detecting and treating rejection of transplanted kidneys “may have brought the day of completely successful body part transplants considerably closer.” One of the main advantages of the technique, the article reported, was that it provided “a guide for controlling the dosage of anti-rejection drugs.” Before Kountz’s discovery, the average survival time for laboratory dogs with transplanted kidneys was only 40 days. Those that failed to succumb from organ rejection often died from an overdosage of anti-rejection drugs.

In 1965 and 1966 Kountz served as a visiting Fulbright professor of surgery in the Arab Republic of Egypt. While there, he performed the first successful kidney transplant in the Middle East—an achievement that earned him wide recognition in both local and international circles. On his return to the United States, he was appointed assistant professor of surgery at Stanford. In 1967 he left Stanford to become associate professor of surgery and chief of the Kidney Transplant Service at the University of California, San Francisco. It was there, in the late 1960s and early 1970s, that he completed his most important work.

Soon after he arrived at the University of California, Kountz joined forces with a team of other researchers to develop a machine capable of preserving kidneys for up to 50 hours after removal from a donor’s body. Named the Belzer kidney perfusion machine in honor of Dr. Folkert O. Belzer, Kountz’s partner, it is now an indispensable aid in kidney transplant surgery. Kountz later helped develop a number of new techniques in transplantation and greatly advanced the accuracy and sophistication of tissue-typing tests that are crucial to the success of transplant operations.

Campaigned for Organ Donation

Another of Kountz’s major concerns was the shortage of donor organs for transplants. Both at the University of California, San Francisco (UCSF), and at the Downstate Medical Center in Brooklyn, he devoted much of his time and energy to raising public awareness of the need for organ donation. “Kountz believed that organ transplantation was a means of prolonging life, as he often said, ’so that a person can be kept alive at 20 to die of something else at 65,’” wrote Jini Kilgore Robinson in the UCSF Journal. His real motivation, however, came from the kidney patients he had observed and with whom he had worked. “So many of them were young people with whom I could identify,” he was quoted as saying in a press release from Downstate Medical Center. “I recognized that if this organ could be successfully replaced, a young person could have a long, productive life.”

Transplantation was a new and highly controversial area, however, and Kountz’s pleas for donor organs were met with anger and skepticism. “Public opinion about a person having a vital organ removed from his body to give to a total stranger was: ’He must be crazy! ’” Dr. Harrison Sadler, Kountz’s close friend and colleague, told the UCSF Journal. “But Sam said, ’I don’t think so. That’s a great act of altruism.’” His efforts to establish an official protocol for organ donation led to the first full-scale study of prospective donors. Before they were allowed to donate a kidney, 22 donors underwent six months of close physical and psychological evaluation. They were then observed for a full 10 years following the surgery. “None of them were crazy,” Sadler recalled. “This enriched their lives.”

Before he left the University of California, Kountz established the UCSF Center for Human Values, where ministers, theologians, and physicians from many different specialties could meet to discuss the moral and ethical questions posed by transplantation. In an effort to improve the psychological outlook of transplant patients—a factor that had been shown to have a dramatic effect on their recovery and rehabilitation—he introduced a program of intense, personalized nursing care and established a Kidney Transplant Club, where patients could meet to discuss their concerns.

In December of 1972, Kountz left the University of California to become chairperson of the department of surgery at Downstate Medical Center in Brooklyn, a large teaching facility affiliated with the State University of New York. At the same time, he was appointed chief of general surgery at Kings County Hospital. Although he had been offered a number of prestigious positions, he chose Downstate—situated in the heart of a predominantly black, ghetto area of Brooklyn—because of his desire to improve the quality of medical care in the African American community.

Known for Friendliness and Compassion

According to a hospital news release, Kountz’s goal in coming to Downstate was to “duplicate myself ten times over” and to “train people who have to be reckoned with.” He wasted no time in recruiting new staff, establishing research priorities, and improving the hospital’s residency program. In addition, he succeeded in turning Downstate’s fledgling organ transplant unit into one of the best in the nation. In January of 1976 he made medical history once again when he and his surgical team performed a successful kidney transplant on three-month-old Alexandra Kelly, the world’s youngest and smallest transplant patient.

Samuel Kountz’s skill as a surgeon was matched by an extraordinary warmth and friendliness, as well as an unending commitment to his patients. “He was very people-oriented,” his former secretary, Diana Farley, told the UCSF Journal. “His bedside maner led patients to take their relationship beyond the patient-doctor relationship…. He got along with everyone and was very easy to work for. We kept a gurney in his office, because he often spent the night to personally monitor very ill patients.” Former patient Archie Graham, on whom Kountz operated when he was 11, was so inspired by the surgeon’s approach that he decided to pursue a career in medicine, with a specialty in transplant surgery. “I was his 117th transplant,” Graham said in an interview with the UCSF Journal, “[but] he didn’t need to look at my chart. He seemed to know my chemistries by heart…. He cared very much for his patients.”

Over the years, Kountz produced close to 100 articles and investigative reports and co-authored dozens more. Among his many professional honors were the 1964 Young Investigator’s Award from the American College of Cardiology, the Lederle Medical Faculty Award, and Man of the Year awards from the Kidney Foundation of Northern California and the International Congress of the Transplantation Society. In addition, he was the first black person to serve as president of the Society of University Surgeons. He received honorary degrees from the University of Arkansas, the University of California, San Francisco, and Howard University. Both the Kountz-Kyle building at AM&N College in Pine Bluff, Arkansas, and the Kountz Pavilion at Harlem Hospital in New York City were named in his honor.

During a lecture tour to South Africa in 1977, Kountz contracted a crippling brain disease that left him neurologically impaired. He was confined to his bed, unable to communicate or care for himself, for the rest of his life. The illness was never diagnosed, and he died in December of 1981, at the age of 51. In July of 1980 the National Association for the Advancement of Colored People presented an Afro-Academic, Technological, and Scientific Olympics program award—a special high school science prize for African American students—in his honor. Five years later the World’s First International Symposium on Renal (kidney) Failure in Blacks was dedicated to his memory.

Sources

Books

Organ, Claude H., Jr., M.D., and Margaret M. Kosiba, R.N., A Century of Black Surgeons: The U.S.A. Experience, Transcript Press, 1987, pp. 661–95.

Periodicals

Arkansas Gazette, December 23, 1981.

Chicago Tribune, April 20, 1980.

Ebony, November 1964, pp. 119–24; July 1974, p.61.

Journal of the National Medical Association, vol. 73, supplement, December 1981.

New York Post, April 6, 1973.

New York Times, February 15, 1964; December 24, 1981.

UCSF Journal, May 1982, pp. 2–3.

Additional information for this profile was obtained from press releases from Downstate Medical Center, Brooklyn, NY, June 1977 and December 23, 1981.

—Caroline B. D. Smith