Barbara Murphy obituary: Leading kidney transplant expert with passion for research

Irish doctor who died of cancer was president-elect of American Society of Nephrology

Dr. Barbara Murphy in 2010. Photograph: Mount Sinai Health System via The New York Times

Dr. Barbara Murphy in 2010. Photograph: Mount Sinai Health System via The New York Times

 

Barbara Murphy
Born: October 15th, 1964
Died: June 30th, 2021

Dr Barbara Murphy, a leading nephrologist from Ireland who specialised in advanced research that focused on predicting and diagnosing the outcomes of kidney transplants, died last week at Mount Sinai Hospital in the New York City borough of Manhattan, where she had worked since 1997. She was 56.

The cause was glioblastoma, an aggressive form of brain cancer, said her husband, Peter Fogarty.

Dr Murphy blended a passion for research into kidney transplant immunology with her role, since 2012, as chair of the department of medicine at the Icahn School of Medicine at Mount Sinai (and its broader health system). She was the first woman named to run a department of medicine at an academic medical centre in New York City.

“In baseball, they talk about five-tool players,” Dr Dennis Charney, dean of the Icahn School, said by phone. “I don’t know how many tools she had, but she was a very strong administrator, a great researcher and a great mentor to many people.”

The interaction between a living donor and a recipient in the recovery room still makes me proud to be a physician

Dr Murphy developed her interest in kidney transplantation while attending medical school at the Royal College of Surgeons in Ireland (RCSI). She was drawn especially to how it transformed patients’ lives.

“I love seeing how well patients do afterward,” she told Irish America magazine in 2016. “For all the years that I’ve been in this profession, the interaction between a living donor and a recipient in the recovery room still makes me proud to be a physician and to play a part in such a life-affirming moment.”

After being recruited to Mount Sinai in 1997, she joined other researchers in examining the role of HIV in kidney disease and helped establish the viability of kidney transplants for patients with HIV. In a speech at the RCSI in 2018, she recalled that there had been criticism of such transplants – as if there were a “moral hierarchy when it came to donor kidneys”.

She added: “Two weeks ago, we received an email from one of our patients, thanking us on his 15th renal transplant birthday.”

More recently, Dr Murphy’s research at her laboratory at Mount Sinai focused on the genetics and genomics of predicting the results of transplants, and on why some kidneys are rejected.

Dr Barbara Murphy in 2014. Photograph: Roger Tully, via Mount Sinai Health System via The New York Times
Dr Barbara Murphy in 2014. Photograph: Roger Tully, via Mount Sinai Health System via The New York Times

In findings reported in The Lancet in 2016, she and her collaborators said they had identified a set of 13 genes that predicted which patients would subsequently develop fibrosis, a hallmark of chronic kidney disease, and, ultimately, irreversible damage to the transplanted organ. Being able to predict which patients were at risk, they wrote, would allow for treatment to prevent fibrosis.

Her research has been licensed to two companies. One, Verici DX, which is still in validation trials in advance of commercial sales, is developing RNA signature tests to determine how a patient is responding to, and will respond to, a transplant. The other company, Renalytix, uses an algorithm guided by artificial intelligence to identify a kidney disease risk score for patients. Dr Murphy served on the boards of both companies.

“Barbara was foundational to Verici,” chief executive Sara Barrington said by phone, adding, “her lab will continue to file new discoveries out of her base research”.

Barbara Therese Murphy was born October 15th, 1964, in south Dublin. Her father, John, owned an air freight company, and her mother, Anne (Duffy) Murphy, worked with him and also designed bridal wear.

She grew up in Knocklyon and attended Sancta Maria junior school in Ballyroan, Rathfarnham and Alexandra College, Milltown.

At age four, Dr Murphy recalled in a speech at a healthcare awards dinner sponsored by Irish America in 2016, she had to overcome a harsh judgment by a teacher.

“My elementary school teacher told my mother I was a dunce and I would never be anything, and what’s more, she shouldn’t even try,” she said. “Fortunately, my parents persevered.”

After earning her medical degree at the RCSI in 1989, Dr Murphy completed her residency and a nephrology fellowship at Beaumont Hospital. She was also a nephrology fellow in the renal division of Brigham and Women’s Hospital in Boston, where she trained in transplant immunology.

In 1997, she was recruited to Mount Sinai as director of transplant nephrology by Dr Paul Klotman, then-chief of the division of nephrology, who promoted her to his former position in 2003 after he had become chairman of Icahn’s department of medicine.

“She showed a lot of promise in transplant nephrology, which was emerging at the time,” Dr Klotman, now president of the Baylor College of Medicine in Houston, said by phone. “Over the years, she developed good leadership skills: She was very organised and task oriented.”

In the spring of 2020, Dr Murphy, like other physicians, noticed with alarm that Covid-19 was much more than a respiratory disease. It was causing a surge in kidney failure that led to shortages of machines, supplies and personnel needed for emergency dialysis.

The number of patients needing dialysis “is orders of magnitude greater than the number of patients we normally dialyse,” she told The New York Times.

One of Mount Sinai’s responses to the pandemic that May was to open the Center for Post-Covid Care for patients recovering from the virus. At the time, Mount Sinai had treated more than 8,000 patients who had been diagnosed with Covid-19.

“Barbara was instrumental in forming the centre,” Dr Charney said, “and she was involved in the follow-up as it related to kidney disease caused by Covid”.

Dr Murphy was given the Young Investigator Award in Basic Science from the American Society of Transplantation in 2003 and was named nephrologist of the year by the American Kidney Fund in 2011. At her death, she was president-elect of the American Society of Nephrology.

In addition to her husband, Dr Murphy is survived by their son, Gavin; her sister, Celine; her brother, Kieran, and her parents.

Dr Murphy said she had learned an indelible lesson about the need for a strong patient-doctor relationship while still in medical school.

“Scholarship alone was not enough,” she said at the Irish America award ceremony. “An example: If we had a patient with rheumatoid arthritis and we shook their hands and they winced, it didn’t matter how much we knew about the disease or how to treat it, we’d failed our exam because we hadn’t taken the patient’s overall wellbeing into consideration.”

This article originally appeared in The New York Times.