Risk attitudes in transplantation--then and now

Organ transplantation has become much more organized since its early days, for both good and ill.

Today there's a good deal of regulation of transplant centers, which need very high success rates (one year graft survival rates in particular) to remain in the good graces of government and private payers.

It wasn't always so.

Here's a quote from Lloyd Ratner's Message from the ASTS President for November 2019:

"In the transplant world, this [perseverance] is best exemplified by Thomas Starzl’s ceaseless quest to make liver transplantation a reality. Between March 1963 and May 1967, Dr. Starzl performed his first 7 liver transplants at the University of Colorado, all of whom died in the peri-operative period. The longest survivor succumbed after 23 days to “sepsis, bile peritonitis, and liver failure.” Despite this disastrous start, Dr. Starzl persevered. Starzl’s eighth patient, transplanted for hepatocellular carcinoma, lived 400 days before dying from carcinomatosis. By 1990 the programs that Dr. Starzl directed in Pittsburgh would perform 571 liver transplants in a single year and would train many of the world’s leaders in the field."