PITTSBURGH — Dr. Thomas Starzl, who pioneered liver transplant surgery in the 1960s and was a leading researcher into anti-rejection drugs, has died. He was 90.
The renowned doctor died March 4 at his home in Pittsburgh, according to the University of Pittsburgh, which he joined in 1981, making the city a key transplantation center.
Starzl got his medical degree from Northwestern University. He went on to performed the world’s first liver transplant in 1963 and the world’s first successful liver transplant in 1967. And he pioneered kidney transplantation from cadavers. He later perfected the process by using identical twins and, eventually, other blood relatives as organ donors.
Since Starzl’s first successful liver transplant, thousands of lives have been saved by similar operations.
“We regard him as the father of transplantation,” said Dr. Abhinav Humar, clinical director of the Thomas E. Starzl Transplantation Institute at the University of Pittsburgh. “His legacy in transplantation is hard to put into words. It’s really immense.”
Starzl joined the University of Pittsburgh School of Medicine in 1981 as a professor of surgery. His studies there on the anti-rejection drug cyclosporin transformed transplantation from an experimental procedure into one that gave patients a hope they could survive an otherwise fatal organ failure.
It was Starzl’s development of cyclosporin in combination with steroids that offered a solution to organ rejection — the key hurdle to a successful transplant.
Until 1991, Starzl served as chief of transplant services at UPMC, then was named director of the University of Pittsburgh Transplantation Institute, where he continued research on a process he called chimerism, based on a 1992 paper he wrote on the theory that new organs and old bodies “learn” to co-exist without immunosupression drugs.
The institute was renamed in Starzl’s honor in 1996, and he continued as its director.
In his 1992 autobiography “The Puzzle People: Memoirs of a Transplant Surgeon,” Starzl said he actually hated performing surgery and was sickened with fear each time he prepared for an operation.
“I was striving for liberation my whole life,” he said in an interview.
Starzl was born March 11, 1926, in LeMars, Iowa. His mother was a surgical nurse, and his father was a science fiction writer and the publisher of the local newspaper.
After getting his bachelor’s degree in biology from Westminster College in Fulton, Mo., Starzl got a master’s degree in anatomy in 1950 from Northwestern University’s medical school, where he went on two years later to earn both a medical degree with distinction and a doctorate in neurophysiology, according to the Pittsburgh Post-Gazette.
Starzl later did a residency at the Veterans Administration Research Hospital in Chicago and served on Northwestern’s faculty from 1958 to 1961.
His career-long interest in research began with a liver operation he assisted on while a resident at Johns Hopkins Hospital in Baltimore. After the surgery to redirect blood flow around the liver, he noticed the patient’s sugar diabetes also had improved.
Thinking he had found the cause of diabetes to be in the liver rather than the pancreas, he designed experiments in 1956 with dogs to prove his discovery. He was wrong, but that started him on the path that would lead to the first human liver transplants at the University of Colorado in Denver seven years later.
In the early 1990s, livers from baboons were transplanted into humans, an operation made possible by Starzl’s research into alternatives to scarce human livers. While work continues on such animal-to-human transplants, most researchers now focus on pigs rather than primates and use genetic engineering to try to knock out some proteins most involved in causing acute rejection, Humar said.
Starzl’s other accomplishments included inventing a way to route the blood supply around the liver during surgery to make possible the marathon hours required to complete operations involving that complex organ.
He also showed that “soldier cells” from the transplanted organ become “missionary cells” that travel throughout the new body and find new homes, apparently helping the body accept the foreign organ.
Doctors came from around the world to train with Starzl, often going on to head their own transplant units elsewhere.
With Dr. John Fung — his protege in Pittsburgh and successor as director of transplant surgery, who’s now director of the University of Chicago Transplantation Institute — Starzl helped develop the use of the experimental anti-rejection drug FK506.
FK506 — discovered in a soil sample by Japanese researchers and known as tacrolimus — is still the world’s most widely used immuno-suppressing drug. Its use paved the way for more complicated transplants of multiple organs, including the difficult small intestine.
In September 1990, at 65, Starzl put away his scalpel for good, soon after the death of a famous young patient: a 14-year-old girl from White Settlement, Texas, named Stormie Jones. Starzl also underwent a heart bypass operation in 1990 and suffered lingering vision problems from a laser accident five years earlier.
Stormie lived six years after a combination heart-liver transplant at 8 years old but needed a second liver in 1990 and died within nine months. Her death affected Starzl greatly.
“It is true that transplant surgeons saved patients, but the patients rescued us in turn and gave meaning to what we did, or tried to,” he once wrote.
In a written statement, Starzl’s family said, in part: “He was a force of nature that swept all those around him into his orbit, challenging those that surrounded him to strive to match his superhuman feats of focus, will, and compassion. His work in neuroscience, metabolism, transplantation, and immunology has brought life and hope to countless patients, and his teaching in these areas has spread that capacity for good to countless practitioners and researchers everywhere.
“Nobody who spent time with Thomas Starzl could remain unaffected. He will be greatly missed.”
Starzl is survived by his wife of 36 years, Joy Starzl, son Timothy and a grandchild. His funeral was held on the day he would have turned 91.