Thomas Starzl Biography (1926-)

Nationality
American
Gender
Male
Occupation
surgeon

Thomas Starzl is a world-renowned transplant surgeon. He performed the firsthuman liver transplant in 1963 and was a pioneer in kidney transplantation .He has continued his pioneering work by helping to develop better drugs to make human organ transplants safer and more successful. Starzl has also contributed to the fields of general and thoracic surgery and neurophysiology.

Thomas Earl Starzl was born on March 11, 1926, in Le Mars, Iowa, to Roman F.Starzl, the editor and publisher of the Globe Post, a local newspaper, and Anna Laura Fitzgerald Starzl. He was the second son and was followed by two younger sisters. He finished high school during World War II and enlisted in officers' training school at Westminster College in Fulton, Missouri, in 1944. After his discharge from military service, he entered the premedicalprogram at Westminster College, graduating in 1947. After graduation he immediately returned home to care for his mother, who was suffering from breast cancer. She died less than two months later, on June 30.

In September 1947 he entered Northwestern University Medical School in Chicago. After completing three years of medical school, Starzl took a year off todo research with Dr. Horace W. Magoun , a professor of neuroanatomy. While inMagoun's laboratory, Starzl developed a recording technique to track deep brain responses to sensory stimuli. He and his advisor published the work, which continues to be cited, in 1951. His work in Magoun's laboratory earned hima Ph.D. degree in neurophysiology from Northwestern in 1952, the same year inwhich he received his M.D. Starzl also received an M.A. degree in anatomy from Northwestern.

Starzl enrolled in the prestigious surgical training program at Johns HopkinsUniversity Hospital in Baltimore in 1952. During his time at Johns Hopkins he met and married Barbara J. Brothers of Hartville, Ohio. (The two had threechildren, Timothy, Rebecca and Thomas. The marriage ended in divorce in 1976,in part, Starzl admits, because of his nonstop work schedule.) Starzl stayedin the Johns Hopkins training program for four years, but left in anger whenhe learned he would not be offered the coveted position of chief resident. He went to Jackson Memorial Hospital in Miami for his fifth and final year asa resident. During this time he was attracted to the idea of liver transplantation. In an empty garage on the grounds of Jackson Memorial Hospital, Starzlset up a laboratory and began his research on the liver, doing experimentalsurgeries on dogs he obtained from the city pound. He developed a new technique for removing the liver, the first step in liver transplantation. He published his method, and it quickly became the worldwide standard.

In 1958 Starzl returned to Northwestern, where he had accepted a fellowship in thoracic surgery. He passed the thoracic surgery boards in 1959. More importantly, he received two awards to fund his experimental research. One was a five-year grant from the National Institutes of Health. The other was the prestigious Markle Scholarship, which persuaded him to remain in academic medicine. Starzl was a member of Northwestern's surgical faculty for four years. During that time, he further perfected techniques for liver transplantation.

Starzl accepted a position at the University of Colorado School of Medicine as an associate professor of surgery in 1962, believing it offered better opportunities to develop an active organ transplant program. In the late 1950s surgeons had begun to experiment with the first immune suppressive drugs to prevent the body from rejecting a transplanted organ. As a consequence, transplantations became possible for the first time. Despite his interest in liver transplantation, Starzl considered a human liver transplant to be too risky given current knowledge of immunosuppression. On March 27, 1962, Starzl performed his first kidney transplant operation in Denver. Starzl was to achieve considerable success in kidney transplantation, but his real target was the liver, and he soon turned to that challenge.

On March 1, 1963, five years before the surgeon Christiaan Neethling Barnardundertook the first human heart transplant, Starzl attempted the world's first liver transplant . His patient was a three-year-old boy named Bennie Solisborn with an incomplete liver. The child did not survive the operation because of uncontrolled bleeding. Starzl was widely criticized because he failed inhis attempt, but, undaunted, he tried again in May 1963. This time he gave his patient, a man with cancer of the liver, huge amounts of fibrinogen, a protein that forms blood clots. The operation appeared to be a success, but thepatient died three weeks later from complications due to blood clotting.

During the next few years, Starzl worked to solve the problem of uncontrolledbleeding and tissue rejection. In 1964 he directed the first extensive trialof tissue matching ever attempted. In the early 1960s, the physician Paul Terasaki of the University of California at Los Angeles had developed a methodfor detection of tissue antigens, the agents responsible for organ rejection.This method began the field of human histocompatibility research, the searchfor compatible tissue types. These efforts made it possible to match organ donors and recipients. In addition, Starzl turned his attention to developmentof drugs that would block the immune system from rejecting a new organ.

In the late 1960s Starzl was ready to attempt liver transplantation once again. This time all the attempts were on infants and young children with severeliver disease, and a number of them were successful, although some of the patients who survived the operation died from unrelated illnesses not too long afterwards. By the late 1970s the survival rate for liver transplants had risen to 40 percent.

During the 1970s and early 1980s Starzl's career reputation skyrocketed. He was promoted to professor of surgery at the University of Colorado in 1964 andwas made chairman of the department in 1972. During the late 1970s Starzl was wooed by the University of California at Los Angeles to move his transplantation program there. But he finally settled on the University of Pittsburgh and moved there in 1981. The same year he married Joy Conger, who had been a research technician working on a project with Starzl in Denver.

In the early 1980s the availability of cyclosporin, a new, superior drug to prevent organ rejection, was an encouraging sign to Starzl that the survivor rate for liver transplantation could be raised. However, bureaucratic roadblocks were in the way of using cyclosporin and other promising new drugs in organ transplant operations other than kidney transplantations because they wereconsidered by the federal government to be experimental. Starzl took the problem to the then-acting U.S. Surgeon General C. Everett Koop . Koop suggestedStarzl appear before a government committee at the National Institutes of Health that could approve the operation. Starzl assembled a group of children who had survived liver transplants performed in the 1970s and early 1980s. Theyserved as witnesses to the value of the operation, and after much testimonythe committee approved liver transplantation as a service to mankind.

What followed was a rush by surgeons to begin performing the operation. All came to learn from Starzl and the physicians he had trained, who were scattered across the country. At the same time it became clear that the country needed a national system of organ procurement and distribution. Starzl worked diligently to get a bill passed by Congress in 1984 that would set up such as system. Starzl designed the system at the University of Pittsburgh, which becamethe national standard.

Starzl also enhanced his fame by directing a series of multiple-organ transplants in these years. In 1984 a young child received a heart and liver in a single operation, while a young woman received a heart, liver and kidney in 1986. Starzl's attempts to transplant baboon livers into human patients remainedcontroversial into the late 1980s, however. He had experimented with such transplantations since the early 1960s, performing the first successful one in1989. The patient was dying from hepatitis B, to which baboon livers do not appear to be susceptible. Although the operation was initially successful, a surgical error caused a fatal infection some three weeks later. Although somepeople objected to the use of animals for "spare parts," a major controversyarose over the fact that the patient had been HIV positive. Virtually all medical centers take the position that organ transplants, which require a suppression of the immune system, are inappropriate for patients who have been infected with the virus that also attacks the immune system.

In 1990 Starzl underwent coronary bypass surgery himself, and shortly afterwards retired from active surgery. He now concentrates his efforts on research.He claims that the decision was motivated in part by his emotional involvement with patients, which made the surgeries particularly difficult and stressful for him.

Over the years, Starzl has won many awards and honors and has been awarded many honorary degrees, including a merit Award from Northwestern University in1969, a Distinguished Achievement Award in Modern Medicine in 1969, ColoradoMan of Year Award in 1967, David Hume Memorial Award from the National KidneyFoundation in 1978, and Pittsburgh Man of the Year Award in 1981. Starzl haswritten hundreds and hundreds of scientific papers, averaging fifty papers ayear during the 1980s.

Recent Updates

November 14, 2005: U.S. President George W. Bush announced that Starzlwill receive one of three 2004 National Medals of Science for Biological Sciences at a White House ceremony. The National Medal of Science is the nation's highest honor for science. It recognizes individuals in a variety of fieldsfor pioneering scientific research that has led to a better understanding ofthe world around us. Source: National Academies, www.nationalacademies.org, November 18, 2005; National Science Foundation, www.nsf.gov, November16, 2005.

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