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Across the street at Denver's VA Hospital, a man was admitted for accidental gunshot wounds, and when it became clear that he could not survive, relatives gave permission for the use of his liver in a transplant. As the prospective donor's life ebbed, Surgeon Thomas E. Starzl opened Mrs. Goodfellow's abdomen to get her ready for a quick transplant. This operation took ten hours. Her liver was so enlarged by disease that instead of a normal 4 Ibs. it weighed closer to 20 Ibs. Dr. Starzl left his patient anesthetized, with her liver "just sitting there" until it was time for the final cuts to remove it.
Within minutes after the donor died, Ralph Huntley, a mechanical engineer who has switched to biophysics, began cooling the body "from the inside out" by perfusing it with chilled saline solution. He kept this up while Surgeon Thomas Marchioro cut out the liver. Dr. Starzl cut out Mrs. Goodfellow's diseased liver at almost the same moment as its replacement arrived in a chilled, sterile container. Then Dr. Starzl stitched the newly arrived liver in, connecting its blood vessels to their counterparts in Mrs. Goodfellow's body. This part of the operation took 164 minutes.
For days, Mrs. Goodfellow was kept in sterile isolation: the danger of infection had increased enormously because Mrs. Goodfellow's defenses against it had been weakened by the immunosuppressive drugs, Imuran and prednisone, that the doctors had given her to increase the likelihood that the liver graft would "take" instead of being rejected. Last week she was well enough to take a ride outside the hospital, but the crucial time, determining whether her system will accept or reject her grafted liver, is not likely to come until early in November.
Dr. Starzl's Denver team also performed the spleen transplant between mother and son. The boy, Richard Hill, suffered from a shortage of gamma globulin in his blood, leaving him virtually defenseless against infectious diseases. This shortage arose largely from the failure of his spleen to produce enough of the antibodies that make up an important fraction of gamma globulin. The boy's mother, Mrs. Jacqueline Carver, had a good supply of gamma globulin, and her lymphatic system would maintain it. She could get along without her spleen far better than her son. The operations were performed in June, and the boy has been getting doses of Imuran in hopes of subduing his body's reactions against "foreign" tissue, from even so close a relative as his mother. "It will be six months or so before we know whether the transplant is working," says Dr. Starzl.
Second Chance. So alert and powerful are the body's defenses against invasion by proteins from any other body, human or animal (except an identical twin), that some transplant researchers believe donor and recipient should be "look-alikes." An eloquent exception to that argument is a long-surviving kidney transplant, now more than a year old, from a fatally injured Negro to a white man.