Dr. Rudi Schmid, 85; played key role in developing U.S. liver transplant system
Dr. Rudi Schmid, an expert in diseases of the liver, a former dean of medicine at UC San Francisco and a key player in bringing about a nationwide system of liver transplantation, died in his sleep Oct. 20 at his home in Kentfield, Calif. He was 85 and had been suffering from pulmonary failure.
The first U.S. liver transplant was performed in 1963 and the first successful one four years later. By 1983, a little more than 500 transplants had been performed, primarily at four medical centers, and the one-year survival rate hovered between 20% and 25%.
The National Institutes of Health convened a consensus panel to consider whether the procedure should be more widely adopted, appointing as chairman the newly installed UC San Francisco dean.
Under Schmid’s guidance, the panel concluded that liver transplants should be broadly available but that they should be performed only at major medical centers where a host of ancillary services were available in case of problems.
The guidelines issued by the panel were widely accepted, and today more than 5,000 liver transplants are performed each year at more than 100 U.S. medical centers -- the major limitation being the number of donor organs available. One-year survival rates have climbed to near 90%.
Schmid had been recruited by UC San Francisco in 1966 to establish a division of gastroenterology at the medical school. Over the next 17 years, he created a strong basic research program, established the prestigious Liver Center and brought 73 people to the faculty.
He was appointed dean with the strong support of the faculty, who saw him as an advocate of basic research. The problem, he later admitted, was “I had absolutely no idea how to run a medical school.” That was solved by a crash course in management and the support of key administrative personnel.
During his six years as dean, he re-engineered the curriculum, putting less emphasis on simple memorization and more on problem solving and clinical care, forcing students out of the classroom and into hospitals. Unlike a similar restructuring at Harvard, the program met with minimal resistance from faculty and students alike because he implemented it over a five-year period rather than all at once.
In recognition of his efforts in transforming UC San Francisco from a good health sciences campus into a premier biomedical institution, last year Schmid was awarded the UCSF Medal, the university’s highest honor.
Rudi Schmid was born May 2, 1922, in Glarus, Switzerland, the son of two general practitioners. He received his medical degree from the University of Zurich in 1947, then went to South America to climb mountains and ski.
Schmid had been an excellent skier since childhood, and he spent three years on the Swiss National Ski Team. While mountaineering in Peru, he met UCSF faculty member Dr. Salvatore Lucia, who promised him an internship in San Francisco.
Mistakenly believing it to be a prestigious postgraduate position, he accepted, learning English with the help of student nurses and by reading everything he could get his hands on.
Skiing also led him to a fellowship with Dr. C.J. Watson at the University of Minnesota, where he first developed his lifelong interest in porphyrins, a key metal-binding component of red blood cells. He earned a doctorate in medical sciences in 1954, the same year he became a U.S. citizen.
Shortly after his naturalization, he received a draft notice, but managed to obtain a fellowship to the National Institutes of Health as an alternative to military service. After two years there, he spent time at Harvard and the University of Chicago before landing in California.
Over the course of his research career, he developed the first animal model for porphyria, a defect in enzymes in the red blood cell that causes skin and neurological problems.
He also studied the chemistry of bilirubin, a breakdown product of hemoglobin that is present at toxic concentrations in some genetic diseases. He and Dr. Ivan F. Diamond, among others, looked at ways to prevent bilirubin from passing into the brains of young children with jaundice.
Schmid is survived by his wife of 58 years, the former Sonja Wild; a son, Peter, of Daly City, Calif.; a daughter, Isabelle Franzen of Cape Town, South Africa; and one grandchild.
