Intended for healthcare professionals


Thomas Starzl

BMJ 2017; 357 doi: (Published 11 April 2017) Cite this as: BMJ 2017;357:j1806
  1. Janet Fricker
  1. Hemel Hempstead
  1. janet.fricker1{at}

US pioneer in transplantation and immunology

UPMC/University of Pittsburgh

Thomas Starzl, the surgeon who performed the world’s first liver transplantation in 1963, the world’s first successful liver transplantation in 1967, and the first simultaneous heart and liver transplantation in 1984, never enjoyed the surgical process. Starzl, who also undertook pioneering work to prevent organ rejection, described his “intense fear” of failing patients. “It was as if I had trained all my life to become a violin virtuoso, only to discover that I loathed giving concerts or even playing privately,” he wrote in his 1992 autobiography,1 named by the Wall Street Journal as the “third best book on doctors’ lives.”

“Tom may not have liked surgery, but he was very good at it,” said Roy Calne, the UK surgeon who performed the first European liver transplant in 1968.

“Starzl was an iconic figure in transplantation, and many regard him as the father of transplantation. He took it from its infancy and made it mainstream,” said Abhinav Humar, clinical director of the Thomas E Starzl Transplantation Institute at the University of Pittsburgh.

A series of firsts

On 1 March 1963, while working at the University of Colorado, Starzl performed the first human liver transplant. His realisation that liver transplantation could be used in a variety of metabolic conditions had been triggered after conducting studies in dogs, exploring whether portal vein nutrients contribute to liver health.2 His first patient, a 3 year old boy with biliary atresia, bled to death during surgery.3

UPMC/University of Pittsburgh

Starzl’s subsequent four liver transplant patients survived surgery but died from multiple infections and pulmonary emboli within a few weeks. Surgeons worldwide declared a moratorium on the procedure, forcing Starzl back to the drawing board to devise new procedures, such as bypassing blood from the lower to the upper half of the recipient’s body with …

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