Attempted First Liver Transplants
Starzl was not satisfied with his success in the field of kidney transplantation. He was still determined to transplant livers. His first attempt was on March 1, 1963, on a three-year-old boy, Bennie Solis, who was born with an incomplete liver. Uncontrolled bleeding killed Solis. Starzl tried again in May of 1963 with a man suffering from cancer of the liver. Starzl tried to solve the bleeding problem by administering huge amounts of fibrinogen, a protein that forms blood clots. The operation appeared to be a success, but the man died three weeks later from complications due to blood clotting.
The paramount problems to be solved were uncontrolled bleeding and tissue rejection. Starzl suspended human liver transplantation to work on these issues. He also worked on the manuscript for his first book, Experience in Renal Transplantation. He also suffered a bout of hepatitis which was all too common at that time for transplant personnel. In 1964 he and his colleagues closed their transplant center for six months in order to set up the first extensive trial of tissue matching ever attempted. Starzl worked with Dr. Paul Terasaki from the University of California at Los Angeles. Terasaki concluded that tissue matching within families was feasible, but that it had limited value with unrelated donor kidneys. It was clear to Starzl and Terasaki that the solutions to organ transplant rejections lay in the development of better drugs and other treatment strategies. Starzl theorized that organ rejection could be controlled by using the steroid prednisone along with Imuran. He soon added the anti-lymphocyte globulin and another immunosuppressant, cyclosporin. The use of this combination of drugs advanced kidney transplantation from an experimental procedure to a standard procedure.
Performed First Successful Liver Transplants
In 1967 Strazl felt that the surgical techniques and immunosuppressant drugs had advanced enough to begin liver transplant trials again. The first attempts were on infants and young children with severe liver disease. Some of the operations were successful, while others failed because of the severity of the illnesses some of the patients had. By the late 1970s the survival rate for liver transplants had risen to 40 percent. Starzl was promoted to chair of the department from 1972 until he moved to the University of Pittsburgh in 1981.
While Starzl's professional life was extremely successful, his personal life was in shambles. His wife of 22 years divorced him intending to marry a wealthy Middle Eastern businessman. He felt that she rightly was tired of being a distant second to his career. His father, who had become totally paralyzed, died at about the same time. Next, his sister, Nancy, died of liver disease and he was unable to get to her in time. His son, Tim, was also hospitalized with an emotional breakdown. In March 1977 Starzl assembled a new research group. One of the researchers was a young woman, Joy Conger, who would become his second wife in 1981.
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In 1981 Starzl joined the staff of the University of Pittsburgh School of Medicine as professor of surgery. For the next ten years he oversaw the largest transplant program in the world at Presbyterian University Hospital (UPMC Presbyterian), Children's Hospital of Pittsburgh, and Oakland Veterans Affairs Medical Center. Ultimately, he became the director of the University of Pittsburgh Transplantation Institute which was renamed the Thomas E. Starzl Transplantation Institute (STI) in 1996. In 1998 he retired as director but continued to be active in research.
Performed Successful Baboon-to-Human Transplants
Starzl engaged in significant work during his tenure at the University of Pittsburg Transplantation Institute. He got the National Institutes of Health to approve the drug cyclosporin for liver transplants. In 1984 he helped to get a bill passed by Congress which set up a national system of organ procurement and distribution. He and his researchers have improved the outcomes of liver, kidney, pancreas, and multiple organ transplantations. In 1986 Starzl and his team successfully completed their pivotal work on the anti-rejection drug tacrolimus which has benefited nearly 5,000 patients. To address the chronic shortage of human organs, Starzl and his team have looked into the feasibility of cross-species transplantation, or xenotransplantation. In 1992 and 1993, Starzl and his team performed two successful baboon-to-human liver transplants, making medical history.
In 1990 Starzl underwent coronary bypass surgery. He retired from active surgery and wrote his autobiography, The Puzzle People: Memoirs of a Transplant Surgeon. The idea for the title was given to him by an Indian journalist who asked him if in the next decade a puzzle man with multiple organs from various human and non-human sources would be feasible. After contemplating the idea, he decided that every patient who receives an organ is a puzzle because of all the ways the body has to change in order to accept the gift. Starzl continued to be active in research. He changed his concentration to chimerism, the coexistence of donor and recipient cells. Starzl now believed that the immune system no longer needed to be suppressed. The body could be fooled into believing that the transplanted tissue was not foreign. The trick was to convince both the body's defense mechanism and the new organ that the intruder is really "self," a recognized member of the host body.
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Many of Starzl's ideas are still controversial, especially the animal to human transplants. He continues to speak throughout the world and is one of the most prolific writers in his field with four books, 2,076 scientific articles, and 283 chapters.
Books
American Men and Women of Science 1998-99, 20th Edition, R.R. Bowker, 1999.
Notable Twentieth-Century Scientists, Gale Research, 1995.
Starzl, Thomas E., Puzzle People: Memoirs of a Transplant Surgeon, University of Pittsburgh Press, 1992.
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