Guy Alexandre, Transplant Surgeon Who Redefined Death, Dies at 89

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His willingness to remove kidneys from brain-dead patients increased the organs’ viability while challenging the line between living and dead.

Guy Alexandre, a Belgian transplant surgeon who in the 1960s risked professional censure by removing kidneys from brain-dead patients whose hearts were still beating — a procedure that greatly improved organ viability while challenging the medical definition of death itself — died on Feb. 14 at his home in Brussels. He was 89.

His son, Xavier, confirmed the death.

Dr. Alexandre was just 29 and fresh off a yearlong fellowship at Harvard Medical School when, in June 1963, a young patient was wheeled into the hospital where he worked in Louvain, Belgium. She had sustained a traumatic head injury in a traffic accident, and despite extensive neurosurgery, doctors pronounced her brain dead, though her heart continued to beat.

He knew that in another part of the hospital, a patient was suffering from renal failure. He had assisted on kidney transplants at Harvard, and he understood that the organs began to lose viability soon after the heart stops beating.

Dr. Alexandre pulled the chief surgeon, Jean Morelle, aside and made his case. Brain death, he said, is death. Machines can keep a heart beating for a long time with no hope of reviving a patient.

His argument went against centuries of assumptions about the line between life and death, but Dr. Morelle was persuaded.

They removed a kidney from the young patient, shut off her ventilator and completed the transplant within a few minutes. The recipient lived another 87 days — a significant accomplishment in its own right, given that the science of organ transplants was still evolving at the time.