John Salaman, a Transplant Surgeon and Academic who died on 16 of February 2018, contributed hugely to the successful treatment of kidney patients in Wales throughout his distinguished career.

Professor Salaman was involved from the very beginning of organ transplantation in Wales and played a key role in shaping the development of treatment for kidney disease.

Kidney Wales Chief Executive, Professor Roy J Thomas said: “John had a gentle modesty, and as such was a successful and skilled surgeon, this was endearing to his patients. He operated with professionalism and held an impeccable bedside manner which created lasting bonds with his patients. He was a world player; a man that created the strong shoulders we now stand upon to support kidney patients in Wales.”
Born in the County of Essex on the 14th of October 1937 where his Father was a GP in Stanstead.

John Salaman trained at Cambridge University with the world-leading pioneer in organ transplantation, Professor Sir Roy Calne, where he spent two years as a research fellow carrying out innovative kidney transplant experimentation.

In 1969, John moved to the London Hospital where he held a lecturer post on the Professorial Surgical Unit for a year.In the October of 1970, Mr. John Salaman was appointed as the Senior Lecturer in Transplantation in the Cardiff Royal Infirmary (CRI). His new position was particularly innovative, consisting of both operating and research work, with 9/11ths being NHS and 2/11ths academia.

The CRI was the principal hospital at the time and was the centre for carrying out haemodialysis. At the CRI, David Crosby, a surgeon who carried out the first ever kidney transplant in Wales at Llandough Hospital in 1967, was instrumental in appointing John. David managed a four-bed annex on Ware Ward, and this became the Renal Transplant Unit for thirteen years.

During the late 1960s kidney transplantation started being offered to patients with renal failure who were on chronic dialysis programmes. As the process was in its infancy, patients regularly developed life-threatening infections resulting in a 30% mortality. The main reason for this was that at the time the standard immunosuppression, which is what helps the body prevent rejection of the kidney in the new recipient, was Azathioprine and Prednisolone. These immunosupressors were not the most effective at suppressing rejection as only 45% of the grafts would survive for more than one year.

John Salaman, was made a Professor in 1984. Apart from Professor Salaman and an assistant, the transplant team comprised of a Senior Registrar, a Research Fellow and a Senior House Officer, plus administrative and secretarial services.

Kidney Wales, formerly known as KRUF and established in 1967, funded the appointment of another key member of the transplant team at a later date. The leading Welsh kidney charity supported the introduction of a Transplant Co-ordinator, which are known today as Specialist Nurses for Organ Donation.

Kidney Wales celebrated its 50-year anniversary in 2017, with its continued world-leading campaigning on the importance of organ donation. John held an association of 48 years with Kidney Wales. He also held the position of President of the Welsh Kidney Patients Association until recently, which was funded in its initial years by Kidney Wales at his and others’ request.

The Charity chose to support the building of a new nine bed Transplant Unit. There had been an isolation Ward at the Cardiff Royal Infirmary, which was used to nurse highly infectious cases. It was part of the hospital complex but could only be entered through an outside door. The ward became vacant in 1972 when the University Hospital of Wales opened and accepted most of the acute services, but not Nephrology, Dialysis or Transplantation. Plans were therefore prepared to convert this area into a Transplant Ward, which involved building a new interior staircase and lift.

Kidney Wales fundraised with the South Wales Echo and Argus newspapers to seek donations to the building fund, and in eight weeks £120,000 was raised. The new unit was opened by the Secretary of State for Wales in 1982.

The main beneficiary of Kidney Wales’s fundraising, apart from the transplant unit, was the “KRUF Institute of Renal Disease”, which was located at the CRI within the side building that previously housed the Department of Medicine, prior to its move to the new hospital. The head, Professor William Asscher, later known as Sir William Asscher, offered the ground floor and the top floor to be used for transplantation research; here John Salaman and his technician would undertake their experiments in the ground floor laboratory, whilst the top floor was used for Transplant Immunology.

John had been successful in attracting a number of grants to support this work, including a major Programme Grant from the Medical Research Council. The main research effort was to develop better Immunosuppressive drugs. The development of Cyclosporin was carried out by Professor Burell in the Sandoz laboratories in Switzerland which led to the transformation of transplant practice. From the introduction of Cyclosporin, transplant and patient survival rates improved substantially, and the Cardiff unit was able to participate in a number of key clinical studies using this agent.

By the time Professor John Salaman reached his retirement, he and his team were performing 90 kidney transplants a year, and had collectively performed over 1500 transplants since the unit’s inception and successfully started a pancreatic transplantation programme for sufferers of diabetic renal failure. The team’s thousandth’s kidney transplant patient was an owner of a large Chinese restaurant in Cardiff, who subsequently invited the whole team to his restaurant to celebrate.

The clinical and research teams published over 130 papers, and of which John Salaman was an author of and contributed to several books. John served as a Trustee of Kidney Wales from 2002 to 2017.

Kidney Wales Chief Executive, Professor Roy J Thomas said: “I first met John in 1984 at Cardiff’s City Hall at the launch of the first computerised organ donor registry “Lifeline Wales”, and was inspired by his commitment to the cause. He backed our recent deemed consent law and campaigned with us.”

He added, ” When I became Chair of Kidney Wales in 2002 my first call was to John. Without him we would not be where we are now. We created the John Salaman Travelling Scholarship in 2017 in our 50th year and celebrated his work at a major dinner in May 2017. John was presented with a picture of himself with the Princess of Wales who helped launch ‘Lifeline Wales’. He was not one to be in the lime light , but loved meeting patients especially those who he had transplanted. He always backed you if in any need, and his wisdom was invaluable to us at Kidney Wales – I will miss his emails, his towering intellect and his smile, and despite his ill health in recent times he would never miss a meeting. Family was important to him and our thoughts are with all his family at this time.”

John is survived by his life companion and supportive wife Pat Salaman who was herself the Consultant Oncologist and one time Medical Director of Velindre Cancer Care Hospital and four children and seven grandchildren.

To include a personal message within a book of remembrance which will be presented to Professor John Salaman’s family please email your full name and message to team@kidneywales.cymru

PHOTO: John was welcomed and introduced in Kidney Wales 50th Year celebrations by Elinor Power, whose transplant was undertaken by John when she was 3 years of age. Elinor is now married and is now 38 years of age and is pictured here with John in the celebrations with Kidney Wales on his retirement.

For more information on Salaman Scholarships, click here