Pulse
In His Own Words
Transplant legend John Najarian on his life and work.
By Kim Kiser
The University of Minnesota’s Witness to History lecture series recently featured John Najarian, M.D., a surgeon who put Minnesota on the map during the 1970s and ’80s as a leader in organ transplantation. Under his guidance, the University of Minnesota earned a reputation for performing transplants in high-risk, medically complex patients who would have been turned down elsewhere, including children, older adults, and diabetics.
Najarian was involved in a number of transplantation firsts—including the world’s first transplant of insulin- producing islet cells from a deceased donor, of a partial pancreas from a living related donor, and of islet cells from a living donor. He also is known for developing the anti-rejection drug ALG (anti- lymphocyte globulin). He became embroiled in a scandal related to the handling of its manufacture and sale; in 1996, federal charges brought against him were thrown out. By then, Najarian had resigned from his position as head of the department of surgery at the university. But he remained on the faculty, and at age 83 he still does surgery and research.
Assistant professor of family medicine and community health Jon Hallberg, M.D., moderated the discussion with Najarian in March, which traced Najarian’s career and highlighted his contributions to the field of transplantation medicine. The following are some excerpts from the talk.
At a Glance
- Appointed professor and chair of the department of surgery at the University of Minnesota in 1967; named Regents Professor, the university’s highest honor, in 1986
- Admitted to the Royal College of Surgeons in England in 1987
- Recipient of the 2004 Medawar Prize, deemed the world’s most prestigious for outstanding achievement in organ transplantation
- Has done more than 6,000 solid-organ transplants
- Has published more than 1,300 articles
Source: Najarian J. The Miracle of Transplantation: The Unique Odyssey of a Pioneer Transplant Surgeon. Phoenix Books, Inc. San Francisco. 2009.
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On becoming a surgeon
I didn’t want to be an internist who is going to sit around and scratch his beard and think about things. Rather, I wanted to be in a position where I could get something done. Surgery is one of those areas.
On studying immunology after becoming a surgeon
Immunology is what it’s all about. Immunology is you. The reason you’re able to live in this environment in which you are attacked by various viruses and bacteria is because you have an immunological mechanism that allows you to defend against these things. You’re born with it. … We started out with the wrong idea that a child should be able to receive a transplant without any problem. We learned early that for the first six months, a child has such a strong immune system that he will reject anything so he can survive.
On transplanting adult-sized organs into children
A kidney is as big as a fist. It fills a child’s entire abdomen. We had to work out a technique to put them in. The beauty of it is that the kidney shrinks to the size of the child. As the child grows, the kidney grows.
On how long an organ can function
If everything is equal and you don’t lose your life because of cardiac disease or cancer or getting hit by an automobile, you are destined to live 120, maybe 125 years. So if you take out an organ from someone who is 90 years old, it has 30 years to go. A lot of people don’t think about that. … We have transplants [organs] that are over 100 years of age.
About medicine and surgery becoming so specialized
I was a general surgeon. Sixty to 70 percent of the things I did were general surgery. I tried to train my people that way. If you get into a situation where you’re doing a transplant and there’s a problem and you have to resect a bowel, you don’t want to have to call someone in to do it. I want you to be a general surgeon who does transplantation. I do not want you to be a transplant surgeon. Unfortunately, that doesn’t work now.
On retirement
If you enjoy what you’re doing, why leave? … I think once you do retire you must be very careful. It’s so easy to get into the position of watching television and reading books and what not and not getting involved with people and being part of the communication cycle. I think that leads to what we call senile dementia.
On his current research
We’re looking at organs from other species. We’re raising pigs here that ... are totally clear of bacteria or disease of any sort. … It won’t be long until we’re using pig organs, starting with kidneys and from there livers and pancreases.
The other place we can go is to stem cells. Hopefully, we’ll be able to educate and guide them to make things like insulin. We’re not standing still.