John Najarian, pioneering transplant surgeon
John Najarian, a celebrated transplant surgeon who, by dint of his skill on the operating table and with an anti-rejection drug that landed him on trial in federal court, expanded the lifesaving potential of organ transplants beyond what was once thought to be possible, died Aug. 31 at a nursing home in Stillwater, Minn. He was 92.
He had heart ailments, said his son David Najarian.
Historians of medicine place Najarian in the pantheon of surgeons who developed organ transplantation in the 1950s, ’60s and ’70s, in the process overcoming the skepticism of critics who regarded the procedure as an impossibility, something drawn from science fiction.
“This was the thing that drove me the most,” Najarian once said, according to the St. Paul Pioneer Press, “to find a way that we could in fact transplant organs from one individual to another. Wouldn’t this be wonderful if we could do it?”
The most noted early pioneers in twhe field include the Nobel laureate Joseph Murray, who in 1954 performed the first successful human organ transplant — a kidney transplant between identical twins; Thomas Starzl, who in 1967 performed the first successful human liver transplant; and Christiaan Barnard, who performed the first human heart transplant, also in 1967.
Collectively, these surgeons and others of their generation transformed organ transplants from “experimental treatment into reality,” said Joshua Mezrich, a professor of surgery at the University of Wisconsin School of Medicine and Public Health and the author of the book “When Death Becomes Life: Notes From a Transplant Surgeon.”
Najarian spent most of his career at the University of Minnesota’s medical school, where he built an internationally known transplant program — and cut an unusual profile in hospital corridors.
He stood 6 foot 3, weighed 250 pounds and wore size 15 shoes, according to his son. A former college football star, he was a tackle for the California Golden Bears, played in the 1949 Rose Bowl and declined a chance to join the Chicago Bears in favor of studying medicine.
But in the operating room, he performed devilishly complex surgeries with the precision of a miniaturist. In 1970, Najarian stitched a new kidney into a 6-week-old baby, using magnification to view the child’s minuscule veins. At a time when few other surgeons would perform transplants on children so young, Najarian would review their cases and declare: “I can do it.”
Perhaps his most famous transplant patient was 11-month-old Jamie Fiske, who was born with biliary atresia, a rare condition of the liver and bile ducts. In 1982, after her father made national news with his plea for a new liver for his daughter, Najarian transplanted the liver of a boy killed in an automobile accident. The case was credited with spurring the National Organ Transplant Act of 1984, which formalized a national organ matching network.
Najarian specialized in the transplantation of abdominal organs — kidneys, livers and pancreases. Beyond his pediatric cases, he took on patients many other physicians would have considered too old or sick to be considered for transplants, given the techniques and drugs available at the time. In 1968, according to the University of Minnesota, Najarian and his team performed the first kidney transplant in a patient with diabetes.
The same year he operated on the 6-week-old baby, he operated on a woman of 62, at the time an advanced age for a transplant patient.
“I think we have shown that almost no one is either too young or too old for a kidney transplant,” he said at the time, according to the Minneapolis Star Tribune.
One of the most confounding complications of transplant procedures was organ rejection, in which the recipient’s immune system identifies the new organ as an invader and attacks it. The condition was often fatal, and Najarian “was working in an era when there wasn’t much to give patients to prevent rejection,” Mezrich said.
Najarian distinguished himself in the laboratory as well as in the operating room, refining an anti-rejection drug known as anti-lymphocyte globulin (ALG). His purification and application of the drug “revolutionized outcomes in transplants,” Mezrich said, but also sparked a high-profile legal battle that threatened to derail Najarian’s career.