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Vincent J Freda
OBITUARY
Don Hogan Charles/The New York Times
Obituary
Rights were not granted to include this image in electronic media. Please refer to the printed journal.
Vincent J Freda Developed Rhogam, an anti-D immunoglobuin; Lasker Award winner; professor of obstetrics and gynaecology at Columbia University, New York, USA. Born Dec 16, 1927, in New Haven, Connecticut, USA; died of respiratory failure on May 7, 2003, in New York City, USA, aged 75 years.
n late 1959, Vincent Freda organised the Rhesus Antepartum Clinic at the ColumbiaPresbyterian Medical Center, New York, USA. “He saw babies dying of this disease”, David Zimmerman—whose 1973 book, Rh: the Intimate History of a Disease and its Conquest, chronicled the discovery of Rhogam—told The Lancet. “It was his impetus to see if something could be done to prevent these babies from dying. In some families, baby after baby would die—sometimes four, five, or six in a row.” It was at Columbia, in the early 1960s, that “working with Dr John Gorman, Dr Freda deduced that if anti-rhesus antibody were given at the time of delivery, it would block sensitisation and prevent rhesus disease in the woman’s next rhesus-positive child”, according to Freda’s 1980 Lasker Award citation. “Although his colleagues scorned the idea, Dr Freda and Dr Gorman set out to test this brilliantly simple concept, using pure antibody supplied by Dr William Pollack.” At the same time, Ronald Finn and his colleagues in Liverpool, UK, were working on a very similar idea. “It was the great time of grants at the NIH [National Institutes of Health], and they refused to fund it”, Zimmerman said. “They thought it was nonsense, that it wouldn’t work, and that it wouldn’t make any sense, and they weren’t willing to spend any money to figure it out. And yet it’s probably the cleanest A to Z development that happened in that period. They essentially eliminated this disease as a clinical problem.” Early trials of rhesus immunoglobulin were carried out in prisoners at Sing-Sing Prison in Ossining, a suburb of New York City, where a warden unwittingly played an important clinical role in the eventual timing of Rhogam administration. Originally, Freda’s team planned to inject the volunteers with rhesus-positive blood—to mimic the sensitisation that would occur during a first rhesus-positive pregnancy— and return 24 h later to administer rhesus immune globulin to the treated group but not the controls. But, Freda and colleagues later wrote in the New England Journal of Medicine in 1975, “The warden objected to this ‘obvious’ 24-hour scheduled revisit to the prison over a period of years. We thought of suggesting a 48-hour
I
Ivan Oransky e-mail: [email protected]
THE LANCET • Vol 362 • August 23, 2003 • www.thelancet.com
interval but then realised that with delivery on Friday, the mothers would not receive the rhesus immune globulin until 3 days later on Monday.” As a result, the team suggested a 72-h interval, which achieved 100% protection, and used the same interval in their studies in mothers at Columbia-Presbyterian Medical Center. Other successful studies around the world followed the same protocol, and the US government therefore licensed Rhogam with the 72-h stipulation. Freda, who shared the 1980 Lasker Clinical Medical Research Award with Cyril Clarke, John Gorman, William Pollack, and Finn, was a staunch proponent of Rhogam use. Rhogam is now given routinely to rhesus-negative women after pregnancies in which they carried rhesuspositive fetuses to prevent the mother’s immune system from reacting to the rhesus-positive blood of any subsequent fetus. He used his pulpit when being presented with the Lasker to note that as many as one in five of those women who needed Rhogam at that time were not receiving it. Freda earned a BA from Columbia University in 1948, then attended New York University, from which he earned his medical degree in 1952. He completed his internship at Bellevue Hospital in New York City, and then served as a flight surgeon in the US Air Force in Korea from 1953 to 1955, earning the Korean Service Medal and the National Defense Service Medal. Returning to New York in 1956, he completed his residency in obstetrics and gynaecology at Presbyterian Hospital in 1960. He would serve as a faculty member at Columbia and at Presbyterian Hospital for more than 30 years. In 1959, Freda was the first American doctor to do an amniocentesis. In 1964, Freda and Karlis Adamsons attempted an in-utero transfusion for a 27·5-week fetus with rhesusnegative anaemia. The surgery failed, although it later led to a successful procedure by Adamsons. “All of this stuff was extraordinarily daring at the time. People felt that the womb was sacrosanct”, Zimmerman said. “The fetus was in some special place out of reach of medical efforts. A lot of the research that has led to fetal medicine came out of people doing research on Rh.” Freda is survived by his wife, Carol Ury, his daughter, Pamela, his sons, Andrew and Bradley, and three grandchildren.
669
For personal use. Only reproduce with permission from The Lancet
Don Hogan Charles/The New York Times
Obituary
Rights were not granted to include this image in electronic media. Please refer to the printed journal.
Vincent J Freda Developed Rhogam, an anti-D immunoglobuin; Lasker Award winner; professor of obstetrics and gynaecology at Columbia University, New York, USA. Born Dec 16, 1927, in New Haven, Connecticut, USA; died of respiratory failure on May 7, 2003, in New York City, USA, aged 75 years.
n late 1959, Vincent Freda organised the Rhesus Antepartum Clinic at the ColumbiaPresbyterian Medical Center, New York, USA. “He saw babies dying of this disease”, David Zimmerman—whose 1973 book, Rh: the Intimate History of a Disease and its Conquest, chronicled the discovery of Rhogam—told The Lancet. “It was his impetus to see if something could be done to prevent these babies from dying. In some families, baby after baby would die—sometimes four, five, or six in a row.” It was at Columbia, in the early 1960s, that “working with Dr John Gorman, Dr Freda deduced that if anti-rhesus antibody were given at the time of delivery, it would block sensitisation and prevent rhesus disease in the woman’s next rhesus-positive child”, according to Freda’s 1980 Lasker Award citation. “Although his colleagues scorned the idea, Dr Freda and Dr Gorman set out to test this brilliantly simple concept, using pure antibody supplied by Dr William Pollack.” At the same time, Ronald Finn and his colleagues in Liverpool, UK, were working on a very similar idea. “It was the great time of grants at the NIH [National Institutes of Health], and they refused to fund it”, Zimmerman said. “They thought it was nonsense, that it wouldn’t work, and that it wouldn’t make any sense, and they weren’t willing to spend any money to figure it out. And yet it’s probably the cleanest A to Z development that happened in that period. They essentially eliminated this disease as a clinical problem.” Early trials of rhesus immunoglobulin were carried out in prisoners at Sing-Sing Prison in Ossining, a suburb of New York City, where a warden unwittingly played an important clinical role in the eventual timing of Rhogam administration. Originally, Freda’s team planned to inject the volunteers with rhesus-positive blood—to mimic the sensitisation that would occur during a first rhesus-positive pregnancy— and return 24 h later to administer rhesus immune globulin to the treated group but not the controls. But, Freda and colleagues later wrote in the New England Journal of Medicine in 1975, “The warden objected to this ‘obvious’ 24-hour scheduled revisit to the prison over a period of years. We thought of suggesting a 48-hour
I
Ivan Oransky e-mail: [email protected]
THE LANCET • Vol 362 • August 23, 2003 • www.thelancet.com
interval but then realised that with delivery on Friday, the mothers would not receive the rhesus immune globulin until 3 days later on Monday.” As a result, the team suggested a 72-h interval, which achieved 100% protection, and used the same interval in their studies in mothers at Columbia-Presbyterian Medical Center. Other successful studies around the world followed the same protocol, and the US government therefore licensed Rhogam with the 72-h stipulation. Freda, who shared the 1980 Lasker Clinical Medical Research Award with Cyril Clarke, John Gorman, William Pollack, and Finn, was a staunch proponent of Rhogam use. Rhogam is now given routinely to rhesus-negative women after pregnancies in which they carried rhesuspositive fetuses to prevent the mother’s immune system from reacting to the rhesus-positive blood of any subsequent fetus. He used his pulpit when being presented with the Lasker to note that as many as one in five of those women who needed Rhogam at that time were not receiving it. Freda earned a BA from Columbia University in 1948, then attended New York University, from which he earned his medical degree in 1952. He completed his internship at Bellevue Hospital in New York City, and then served as a flight surgeon in the US Air Force in Korea from 1953 to 1955, earning the Korean Service Medal and the National Defense Service Medal. Returning to New York in 1956, he completed his residency in obstetrics and gynaecology at Presbyterian Hospital in 1960. He would serve as a faculty member at Columbia and at Presbyterian Hospital for more than 30 years. In 1959, Freda was the first American doctor to do an amniocentesis. In 1964, Freda and Karlis Adamsons attempted an in-utero transfusion for a 27·5-week fetus with rhesusnegative anaemia. The surgery failed, although it later led to a successful procedure by Adamsons. “All of this stuff was extraordinarily daring at the time. People felt that the womb was sacrosanct”, Zimmerman said. “The fetus was in some special place out of reach of medical efforts. A lot of the research that has led to fetal medicine came out of people doing research on Rh.” Freda is survived by his wife, Carol Ury, his daughter, Pamela, his sons, Andrew and Bradley, and three grandchildren.
669
For personal use. Only reproduce with permission from The Lancet