Word: organization
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Dates: during 1990-1999
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...wonders of modern medicine, none has captured the public imagination as fully as organ transplantation. Since 1967, when South African surgeon Christiaan Barnard kept 55-year-old Louis Washkansky alive for 18 additional days by giving him a heart taken from a 24-year-old woman killed in an auto accident, these spectacular feats of surgical legerdemain--often involving teams of physicians toiling meticulously for as long as 48 hours--have won headline coverage and created instant heroes of patients and doctors alike...
...same year Barnard replaced Washkansky's heart, performed the first successful liver transplant in Denver. It was Starzl's team at the University of Pittsburgh's Transplantation Institute that made liver transplants routine and fine-tuned the intricate balance of immunosuppression drugs to fight the rejection of transplanted organs by the body's immune system. Now, as he approaches retirement after three decades of spectacular achievement, Starzl has reached the conclusion that he and his colleagues had, for all those years, been going about organ transplantation the wrong...
...great truth Starzl now sees is this: "The mystery was not about [the body's] rejection." It is about the intermingling of cells, the achievement of a peaceful truce between the patient and the donated organ. Rather than beating the patient's immune system into submission with drugs until it accepts the donor organ, Starzl realized, the trick is to convince both the body's defense mechanism and the new organ that the intruder is really "self," a recognized member of the host body...
...defiance of the human immune system, a formidable foe whose chief goal is to reject any and all foreign objects. It accomplishes this by deploying highly specialized cells trained to recognize interlopers, then hunt them down and kill them--even if doing so destroys the very life the donated organ was meant to save. The doctors believed the best weapons they had at their disposal were drugs designed to disable the immune system, if only partially. A mixture of azathioprine, prednisone and antilymphocyte globulin was the choice in the 1960s. In the '80s, cyclosporine proved even more effective...
...Starzl and his colleagues discovered that there was something different about those recipients who had lived much longer--10, 20, as many as 30 years. By testing these patients, they discovered that white blood cells from the recipient's immune system had migrated into the donated organs--and vice versa. What is more, with the encouragement of the antirejection drugs, body and organ had learned to coexist in peace. If scientists could somehow find a way to facilitate that long-term assimilation, Starzl recognized, they could establish the tolerance of transplants more readily and perhaps minimize the use of drugs...