|Introductory Comments by Dr. Clyde F. Barker
University of Pennsylvania Health System, Philadelphia, PA.
Tom Starzl was born in LeMans, a small farming town in Iowa. By the time he finished medical school and a PhD in neurophysiology at Northwestern and surgical training at Hopkins and Miami, it was the early 1960's, an exciting time in science. Two scientific races were underway both in pursuit of fantastic goals that were previously the stuff of science fiction. One race was between the world’s two superpowers for the conquest of space. This one had been an interest of Tom’s father, who in addition to being editor of the town's newspaper had been a widely read pioneer of the genre of science fiction and who had written about space travel. The other scientific goal, less publicized but equally far fetched, was the one that captured the attention of the young Tom Starzl. This was to replace failed organs with spare parts. The contenders in this race were surgeons in two cities: Boston and Paris. Ultimately, neither of them would be the winner.
Starzl is always careful to pay tribute to the pioneering surgeons in Boston and Paris for performing the first handful of kidney transplants which could be accomplished then only by finding identical twin donors or by suppressing the immune response to non twin kidneys with whole body irradiation or the early suppressive drugs. For the further progress of transplantation it was fortunate that the young Starzl rather than becoming a disciple of either group when scarcely finished with his training, chose to establish his own transplant program at the University of Colorado in 1962. At that time, non-twin donor transplants elsewhere had about a 10% chance of success. By employing a new approach to immunosuppression Starzl dramatically improved the outcome. Within a year he had more surviving renal transplant recipients than the rest of the world combined.
However, Starzl’s consuming interest was in transplantation of the liver which in 1963 he was the first to attempt. This project proved so challenging that for a long time, Starzl’s successes were sporadic as he remained virtually the world’s only liver transplant surgeon. In fact, consistent success was not achieved for two decades. By then Starzl had finished a term as Chairman of the Department of Surgery at Colorado and had moved to the University of Pittsburgh. Transplant surgeons agree that without Starzl’s persistence, success of liver transplantation would not have been possible until decades later, if ever.
Dr. Starzl may mention some of the steps by which he improved the outcome of organ transplantation, steps which in large measure were responsible for transforming a highly experimental procedure to the established best treatment for several previously fatal diseases. These crucial steps included the first clinical use of antilymphocyte serum, rescuing the wonder drug cyclosporin from abandonment by devising the appropriate strategy for its use and the introduction of another wonder drug, FK506. For an in-depth review of this progress, I recommend Starzl’s autobiography The Puzzle People, which the JAMA described as “a hard to put down book, more interesting than a thriller.” The book’s New York Times reviewer attributed to Starzl a“flair for clear, vivid writing”, I confess, a somewhat unusual compliment for a surgeon. This “flair” probably stems from Tom’s early work on his father’s newspaper and his employment during medical school as a copy editor for the Chicago Tribune. His style has been further honed by his writing of some 3000 scientific publications. These, by the way according to Dr. Garfield's Institute for Scientific Information, have made him by far the most cited medical author in the world.
I hate introductions that say someone has honors too numerous to mention
but it could be true in Starzl’s case. He is almost certainly the
most widely honored living surgeon.
Over a decade ago, Dr. Starzl stopped operating. At that time
he professed an intent to slow down and devote time to his non-medical
and scientific passions and interests—his wife Joy, his dogs and since
he is a serious student of the cinema to catching up on the movies his
workload had caused him to miss over the previous five decades. So
far, this has not happened. Instead, as Director of the Thomas Starzl
Transplantation Institute at the University of Pittsburgh, he continues
to do perhaps the most important research of his career as he pursues and
pursue the holy grail of transplantation, immunologic tolerance.
In addition, he is kept quite busy accepting awards. It is an interesting
and fitting coincidence that two of his most recent honors have the same
geographic origin—a fellowship awarded last summer in the Royal College
of Surgeons of Edinburgh and tonight’s award endowed by the mysterious
Edinburgh pharmacist, John Scott.