The Department of Veterans Affairs (VA), and the nation as a whole, have benefited from the work of Dr. Thomas E. Starzl, who died March 4 at age 90. Dr. Starzl, regarded as the “father of transplantation,” is credited with performing the first successful liver transplant. As a transplant surgeon and research scientist for more than 50 years, he greatly advanced the science of organ transplantation.
As a physician who was fortunate enough to study under Dr. Starzl, I have a particular appreciation for the medical and scientific genius he embodied. He took full advantage of his enormous talents and skills to help his fellow Veterans, his fellow Americans and people around the world.
Dr. Starzl began his VA career in the 1950s as a resident surgeon in the Chicago VA Medical Center. In 1962, while on the staff of the Denver VA Medical Center and the faculty of the University of Colorado Medical Center, Dr. Starzl conducted the first in a series of successful kidney transplants, with patients surviving longer than had previously been possible. He used the immunosuppressant azathioprine and the steroid prednisone to keep the body from rejecting the new kidney.
Dr. Starzl performed what is considered the first successful liver transplant on May 5, 1963. No patient had survived the operation previously. While Dr. Starzl’s patient did succumb to pneumonia weeks after the transplant, it was still considered a groundbreaking success and paved the way for life-saving procedures for many others in the years to come.
At a National VA Research Week event in 2009, Dr. Starzl reconnected and shared warm memories with an Army Veteran, who was among the first recipients of kidney transplants he had performed in 1962. The two had kept in touch over the years. The man had been able to discontinue anti-rejection medication in the 1990s. Dr. Starzl’s research showed cells from a donated kidney would spread to the rest of the body, eventually enabling the body to recognize the new kidney as its own. Dr. Starzl had studied this phenomenon and called it microchimerism.
Dr. Starzl once said of his early patients: “These men and women who got early transplants were plenty tough. They were great, and they still are.”
In 1963, Dr. Starzl attempted the very first human liver transplant. The patient died during the operation. Several subsequent operations proved that transplanted livers could function, and were considered successful in some regards, but they did not result in long-term survival. Dr. Starzl worked to improve the procedure and began transplanting livers again in 1967. This time, he treated patients with three drugs, including an antibody, anti-lymphocyte globulin, which curbs rejection. Survival times began to exceed one year, and eventually stretched to several decades. Dr. Starzl would follow up with further enhancements to the regimen in future years, such as the introduction in 1980 of cyclosporine, a new anti-rejection medication.
In 2011, Dr. Starzl received the Lasker-DeBakey Clinical Medical Research Award, one of the most respected science prizes in the world, for his career accomplishments. He is one of seven VA researchers to have earned the award.
Dr. Starzl joined what is now the VA Pittsburgh Health Care System and the University of Pittsburgh School of Medicine in 1981. The university named one of its medical research buildings and its transplantation program after him. Even into his late 80s, he remained active in research at the university, mapping the interaction between donor and recipient cells, and developing new ways to further lessen the risk of organ rejection and prevent the harmful side effects of immunosuppressive therapy.
Today, every organ transplant performed by surgeons within VA or any health-care system relies, to an extent, on methods pioneered and developed by Dr. Starzl.
To learn more about VA research, visit www.research.va.gov.