When Death Becomes Life by Joshua D. Mezrich

Author:Joshua D. Mezrich
Language: eng
Format: epub
Publisher: HarperCollins
Published: 2019-01-14T16:00:00+00:00

It was at these national meetings that ideas were shared and, slowly but surely, Thomas Starzl gained recognition as the central force in efforts at liver transplantation. Indeed, it was at the ASA meeting that Starzl first heard about ongoing experiments (both at Richmond with David Hume and at the Brigham) using chemical immunosuppression with a new drug called 6-Mercaptopurine. It became clear to him that chemical immunosuppression was the next step in transplant, and that in order to make liver transplant a reality in humans, he would first need to master kidney transplant and move forward with chemical immunosuppression.

In December 1961, Starzl moved out to Denver, where he was appointed chief of surgery at the Denver Veterans Affairs Medical Center. Within three months of his arrival, he performed his first kidney transplant. Given the generally bad outcomes that were the norm during this period, he was smart enough to start with a pair of identical twins: he felt he had to prove his worth to the local physicians and medical community with at least one good outcome before diving into the insane world of immunosuppression in the 1960s.

By the time Starzl got into the kidney business in 1962, Joseph Murray at the Brigham had already reported his successful case with nonidentical twins and had just introduced the immunosuppressant azathioprine to human transplantation. It would be this same year that he would have his first graft survival with a deceased-donor transplant.

Although Murray was proceeding as quickly as he could, and Hume and Roy Calne were performing transplants at their centers, Starzl jumped in like a freight train. Calne and Murray had identified that azathioprine would be useful in kidney transplantation, but it was Starzl who realized that combining it with high doses of steroids was a better strategy than using azathioprine alone. Many investigators contributed during these early years of transplant, but Starzl, with his large surgical volumes, his ability to push new protocols through uninhibited, and his obsession with writing up his results, played an outsize role.

After his successes in the kidney world, Starzl knew it was time to try his hand at clinical liver transplantation.

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