The Advent of Liver Transplantation

Published Monday December 21, 2020

While the terrible problem of rejection and infection was effectively being addressed by new medications, others in the field had their sights on liver transplantation. Many conditions lead to a patient requiring a replacement liver, including liver cancer, scarring from severe hepatitis C and other liver diseases.

“After solving the rejection problem, I think the next advance that came into place was Dr. Thomas Starzl beginning to develop the whole field of liver transplantation,” said Francisco G. Cigarroa, MD, director of the University Transplant Center.

Dr. Starzl, of the University of Pittsburgh Medical Center, performed the world’s first successful liver transplant in 1967 and made refinements for many years afterward. By the 1980s, liver transplant was the procedure of choice to help save lives of patients with end-stage liver disease who otherwise had no hope of recovery.

“There were many technical issues that needed to be overcome, and in many ways, the liver transplants that we do today, in regard to surgical technique, are not too dissimilar from how Dr. Starzl originated it,” Dr. Cigarroa said.

Dr. Cigarroa and fellow liver transplant surgeon Glenn Halff, MD, of the University Transplant Center proudly welcomed Dr. Starzl to UT Health San Antonio in 2003 to deliver that year’s Presidential Distinguished Lecture.

Dr. Halff, a San Antonio native, completed his postgraduate training under Dr. Starzl’s tutelage in Pittsburgh. His return home in 1992 to begin the University Transplant Center’s liver transplantation program was a major recruitment.

That year, Dr. Halff led the surgical team in the program’s first adult liver transplant. Five years later, in 1997, two notable firsts occurred. Drs. Halff and Cigarroa and the team performed the first split-liver donor transplant between two recipients in South Texas, as well as the first pediatric combined liver/kidney transplant to save a child with advanced liver disease.

Liver transplants, like other types of organ transplantation, were now reliable and lifesaving but were limited by a frustrating problem: the number of donor livers available.

Next: Expanding the Donor Pool to the Living