Edinburgh
In 1957, Woodruff was appointed to the Chair of Surgical Science at the University of Edinburgh without requiring an interview. At the university, he split his time equally between his clinical and teaching responsibilities and his research. He was also allowed to appoint two assistant researchers who went on to become prominent in their own right, Donald Michie and James Howard. As a major part of his research, Woodruff served as the honorary director of a Research Group on Transplantation established by the Medical Research Council.
The research group's principal investigations concerned immunological tolerance (the body's acceptance of tissues, as opposed to rejection), autoimmune haemolytic anaemia (especially in mice), and immune responses to cancer in various animals. In his clinical role, Woodruff started a vascular surgery program and worked with the use of immunotherapy as a cancer treatment as well as the treatment of autoimmune haemolytic anaemia. However, his most important clinical accomplishments were in kidney transplantation.
Most notably, he performed the first ever kidney transplant in the UK, at the Edinburgh Royal Infirmary. Woodruff had been waiting for the right patient for some time, hoping to find a patient with an identical twin to act as the donor, as this would significantly reduce the risk of rejection. The patient that Woodruff eventually found was a 49-year-old man suffering from severely impaired kidney function who received one of his identical twin brother's kidneys on 30 October 1960. Both twins lived an additional six years before dying of an unrelated disease. Woodruff thought that he had to be vigilant with his first kidney transplant, as he regarded the British medical community's attitude to be conservative towards transplantation. From then until his retirement in 1976, he performed 127 kidney transplants. Also in 1960, Woodruff published The Transplantation of Tissues and Organs, a comprehensive survey of transplant biology and one of seven books he wrote. He was awarded the 1969 Lister Medal for his contributions to surgical science. The corresponding Lister Oration, given at the Royal College of Surgeons of England, was delivered on 8 April 1970, and was titled 'Biological aspects of individuality'.
The success of Woodruff's clinical transplant programme was recognised and enhanced by funding from the Nuffield Foundation to construct and open the Nuffield Transplant Surgery Unit at the Western General Hospital in Edinburgh. In 1970 an outbreak of hepatitis B struck the transplant unit, resulting in the death of several patients and four of Woodruff's employees due to fulminant hepatic failure. Woodruff was deeply shaken by the loss and the unit was closed for a period while an investigation was carried out to develop a contingency plan to avoid such a disaster in future. The unit then resumed operations.
Woodruff retired from the University of Edinburgh in 1976 and joined the MRC Clinical and Population Cytogenetics Unit. He spent the next ten years there, engaged in cancer research with an emphasis on tumor immunology using Corynebacterium parva. During that time, Woodruff also published twenty-five papers and two books. After retiring from his cancer research, Woodruff lived quietly with his wife in Edinburgh, traveling occasionally, until his death there on 10 March 2001 at the age of 89.
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