‘Father’ of pioneering transplant
WHEN you consider that Dr Thomas Starzl hated performing surgery, his triumph at carrying out the world’s first successful liver transplant in 1967 is all the more remarkable. Often referred to as the “father of modern transplantation” Dr Starzl received more than 200 awards and honours for his pioneering surgery which subsequently has saved thousands of lives.
But it took years of research, ground-breaking experiments with anti-rejection drugs and a loss of lives before Dr Starzl achieved his breakthrough.
It was in 1967 that the Iowa-born surgeon led a team at the University of Colorado in a procedure that many in the medical profession considered simply impossible.
The patient in question was a 19-month-old girl named Julie Rodriguez who had been diagnosed with liver cancer six months earlier.
She was, according to Dr Starzl, the perfect candidate for a transplant as he believed that “an ideal use of liver replacement would be for patients with cancer that originated in the liver and could not be removed with any lesser procedure”.
Only four years earlier Dr Starzl had attempted five human liver replacements but the first patient had bled to death on the operating table and of the other four, the longest survived only 23 days postsurgery. Similar attempts to transplant a human liver had been made in Boston and Paris but when these also failed a worldwide ban was imposed on the procedure until the summer of 1967.
Following Rodriguez’s surgery on July 23, 1967, Dr Starzl had high hopes of a successful outcome but the little girl’s cancer had spread to other organs and on August 26, 1968, she died. She had lived with her transplanted liver for 400 days and was the first successful case of a transplant patient living longer than a year.
One of the key things Dr Starzl, along with other organ researchers, realised was that if patients were to live longer than months or a few years, more work needed to be done on anti-rejection drugs. In the late 1970s he helped investigate the efficacy of cyclosporine, a drug that laboratory tests indicated could inhibit the body’s immune response.
After trials in which the drug was combined with steroids for the best possible result, cyclosporine was approved by the Food and Drug Administration in 1983. Further progress was made when Dr Starzl began using FK-506, also known as tacrolimus, to prevent rejection. Eventually approved by the FDA in 1994 the drug would go on to become widely used in transplant surgeries.
In 1990 Dr Starzl stopped performing surgery and confessed in his 1992 autobiography that operations had always made him anxious. Each transplant is both a “test of endurance” and “a curious exercise in brutality”, he said. It involved “brutality as you’re taking the liver out, then sophistication as you put it back in and hook up all of these little bile ducts and other structures. Each one is a thread on which the whole enterprise hangs.”
In what he once described as his “uncompromisingly difficult life” Dr Starzl saw his first marriage break down and in later years he suffered poor heath, leading to ulcers, a 60-aday smoking habit and a heart condition for which he underwent bypass surgery in 1990.
He is survived by his second wife Joy and son Timothy from his first marriage to Barbara Brothers. Two children from that marriage, Thomas and Rebecca, predeceased him.