June 20, 2003
UW mourns loss of Dr. Belding H. Scribner
Dr. Belding H. Scribner, professor emeritus of medicine in the University of Washington School of Medicine and an inventor whose device has saved millions of lives, died in Seattle on June 19, 2003, according to the King County Medical Examiner’s Office. Scribner, a member of the School of Medicine faculty since 1951, was honored last fall with one of the world’s major awards for medicine, the Albert Lasker Award for Clinical Medical Research, in recognition of his pioneering work in kidney dialysis.
“Although Belding Scribner is internationally renowned for his innovative clinical research, his motivation always came from his role as a physician caring for patients,” said Dr. Paul Ramsey, UW vice president for medical affairs and dean of the School of Medicine. “Countless people are alive today because of his pioneering innovation. This is a great loss for UW Medicine — and for the medical community worldwide.”
The Lasker Awards are the nation’s most distinguished honor for outstanding contributions to basic and clinical medical research. Scribner was honored along with Dr. Willem J. Kolff of the University of Utah.
The fate of kidney patients has undergone a revolution in the last half-century, due in large part to Kolff’s and Scribner’s seminal contributions.
Hemodialysis has become a universal standard of care for individuals with acute and chronic kidney failure. Furthermore, it is the first — and still the only — method in which a machine replaces a failed internal organ.
In the late 1950s, Scribner encountered a gravely ill patient who was receiving short-term dialysis with an artificial kidney. The patient responded unusually well, and within three days, he was walking along the hospital corridors. But the cure was temporary because it turned out that he had permanent kidney damage. Despite the amazing recovery, he died soon afterward.
Several weeks later, Scribner woke up in the middle of the night with an idea how to save such patients. A U-shaped shunt — with one end inserted into an artery and one into a vein — could remain attached permanently. For each round of dialysis, medical personnel could plug tubes into this device and hook them up to the artificial kidney. Blood would flow from the artery to the dialysis machine and then back to the vein. After dialysis concluded, the apparatus could be capped, which would reconnect the artery and the vein. In principle, such a piece of equipment would facilitate repeated rounds of hemodialysis without destroying all the available veins.
Scribner recalled in an interview for UW Medical Center’s 40th anniversary how, in a chance meeting one day in a stairwell, Dr. Loren Winterscheid, former medical director of UWMC and then chief resident in surgery, suggested Teflon for use in the shunt.
Scribner and his associate, surgeon Dr. David Dillard, contacted engineer Wayne Quinton. Quinton soon mastered the art of bending Teflon, a process similar to glass blowing. Teflon was crucial to the device because it repels virtually all substances; before a blood clot can build up, it slips off. In addition, the material doesn’t react with tissues and can be shaped.
By March 1960, the three men were ready. They implanted the first shunt into Clyde Shields, a 39-year-old machinist who was dying of kidney disease. Although kidney experts doubted that long-term dialysis would succeed because the kidney performs many functions in addition to clearing the blood of toxic metabolites, Shields would live for 11 years on intermittent hemodialysis, and the same therapy would sustain Scribner’s fifth patient, Tim Albers, for 36 years.
Scribner had performed a monumental feat, which allowed continuous replacement of an organ’s vital functions in such a way that a patient could survive with a reasonable quality of life. The advance opened up the field of kidney transplantation. With the Scribner shunt, potential recipients could be sustained while they awaited donor organs. Later, Scribner and his colleagues developed a small, portable device for use in the home, and included features that allowed non-medically trained personnel to operate it safely. This innovation liberated beds in kidney centers and also helped patients incorporate the procedure easily into their normal lives.
Scribner received a number of other awards, including the Gairdner Foundation Award in 1969. He was named to the Washington State Historical Society’s Statehood Centennial Hall of Honor, a project to identify the top 100 people who brought recognition to the state during its first century.
Born in Chicago, Scribner, 82, received his M.D. from Stanford University in 1945. He earned an M.S. degree from the University of Minnesota and an A.B. degree from the University of California. He joined the UW faculty after completing his residency in medicine at San Francisco Hospital and a fellowship in medicine at the Mayo Clinic in Rochester, Minn.
Scribner served as head of the division of nephrology in the UW School of Medicine from 1958 to 1982. He and his wife, Ethel, lived on a houseboat in Portage Bay on Seattle’s Lake Union, where she still resides. For many years, he paddled a canoe across the bay to UW Medical Center and the School of Medicine to work.
For more information about the Lasker Award and to view or read an interview with Dr. Scribner, go to the second-to-last segment at http://www.laskerfoundation.org/awards/thisyear_interviews.html More information is also available at http://www.laskerfoundation.org/awards/library/2002clinical.shtml
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