John Hopewell: Pioneering urologist who led the way in the treatment of kidney failure, both by dialysis and transplantation

His genial presence made working in his theatre a constant delight

Hopewell: his genial, twinkling presence made him a delight to work with

John Hopewell was a pioneering urologist who led the way in Britain in the treatment of kidney failure, both by dialysis and transplantation. Until he became head of the renal unit at the Royal Free Hospital in London haemodialysis was confined to treating acute renal failure; Hopewell introduced the idea of treating chronic cases as well.

He was born in Brixton in 1920, the youngest child and only son of Samuel, a GP from St Helena, and Wilhelmina, who ran the practice. His father had trained at the London Hospital under Sir Frederick Treve, and knew John Merrick, the “Elephant Man”, who was under Treve’s care. An early scientific inspiration for John was one of his father’s patients, Reg Jones, who became Scientific Adviser to the government during the Second World War and led the efforts to disrupt German bomber radio beams by using aluminium strips.

Hopewell won a scholarship to Bradfield College in Berkshire, where he became friends with the author Richard Adams. He was usually near the top of his form, and he entered King’s College, London in 1938 to study medicine – the anatomy and physiology departments decamped to Glasgow for two years during the War, and Hopewell decamped with them. “Glasgow was a lively place then, and the drinking on a Friday night was beyond anything I had seen in the south,” he recalled in his entertaining autobiography, Can You Ever Tell?

He began his rise up the surgical ladder, and after helping treat Allied troops injured after D-Day he joined the Royal Army Medical Corps, serving in India. A useful and enjoyable time was marred by a bout of severe amoebic hepatitis, from which, he said, “my insides never really recovered.” One notable patient during his time there was a pig with a broken leg.

He returned to Britain in 1948, just as the nascent NHS was getting into its stride, securing registrar posts at King’s, first in general surgery – and then, crucially, in urology. Following research work at Buckston Browne Farm, Downe House, site of the Royal College of Surgeons experimental facility, he delivered a well-received Hunterian Oration on the subject of draining urine through intestinal segments. This would be instrumental in helping him be appointed to the Royal Free Hospital in Hampstead, although first there was the post of senior registrar, serving several hospitals in Brighton, as well as a three-month stint in the urology department of the University of California, San Francisco.

In 1957 the Royal Free Hospital in Hampstead was the last of London’s then 13 teaching hospitals to be without a specialist urology department, as the speciality had always come within the compass of the general surgeons there. Indeed, the fact that Hopewell had had a thorough grounding in general surgery helped get him the job.

He believed at the time that the treatment of chronic renal failure was the next important development in medicine, and he worked hard to bring in an artificial kidney machine. He was told at first that there were already two dialysis set-ups in London, which were sufficient for the city’s population, but he pointed out that they were for acute, and not chronic, renal failure. Within 18 months of his arrival a machine arrived from the US – the first in Britain to treat chronic renal failure.

The unit’s progress was speeded up by the arrival of the surgeon Roy Calne (later Sir Roy), who was determined to research the issue of rejection in renal transplantation, and in 1959 two transplants were carried out. Though both recipients died, the procedures were notable for being the first transplants to involve immunosuppressants that had been tested in animal trials.

Hopewell carried out a third, from a father to his son, in 1960, though the patient died of tuberculosis that had been present in the donor kidney; it was the world’s first clinical organ transplant from a live related non-sibling donor using chemotherapy to combat rejection. For the next few years his unit concentrated on maintenance dialysis, the first such programme in the UK. Hopewell set up the London Transplantation Group, which eventually became the National Kidney Register, and transplants resumed at the Royal Free in 1968.

He helped establish the British Transplantation Society in 1972, and was elected its first treasurer. He was president of the Fellowship of Postgraduate Medicine and of the urology section of the Royal Society of Medicine.

On retiring from the Royal Free, Hopewell and his second wife, Rosemary Radley–Smith, a paediatric cardiologist, travelled to St Helena to research the history of his family; he was later the island’s first urological surgeon for a time. They moved to a vicarage at Langrish, Hampshire, where Hopewell worked on the local paper, The Langrish Squeaker. He was also a member of the Society of Ornamental Turners, using a 19th–century turning lathe in his workshop.

As an operating department assistant at the Royal Free Hospital in the early 1980s I can enthusiastically attest that John Hopewell was an absolute pleasure to work with; surgeons can often be intimidating to their staff, divas who treat an operation as a performance. By contrast, Hopewell’s genial, twinkling presence made working in his theatre a constant delight.

John Prince Hopewell, urologist: born London 1 December 1920; Consultant Surgeon, Royal Free Hospital 1957–86; married 1959 Dr Natalie Bogdan (died 1975; one daughter, one son), 1984 Dr Rosemary Radley-Smith; died 14 January 2015.