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FEATURETHOMAS STARZL SAYS TOLERANCEIS ON THE OTHER SIDE OF REJECTIONBY CHUCK STARESINICBREAK ONTHROUGHCONTINUED FROM OUR MAY ISSUEResearchers at theThomas E. StarzlTransplantation Institutebelieve that decadesof laboratory researchand clinical experiencewill yield a systematicway to help transplantpatients tolerate theirnew organs with littleor no medication. Oneavenue of investigationreaches into the depthsof the sea for answers.Oddly enough, jellyfishthat live on the backsof hermit crabs haveoffered clues.In 1986, Thomas Starzl flew to Japan for a chance at a fewdrops of an experimental drug known by the unwieldy designationof FR 900506. The response to his inquiry was,essentially, “Maybe.” After Starzl’s formal request, a Japanesepharmaceutical executive immediately jetted off to London to talkthings over with officials from a British company with which hisfirm collaborated. Starzl, then a Pitt professor of surgery, waited inJapan for a definitive answer.He was 60 years old. He had a reputation for boundless intellectualand physical stamina, not to mention unparalleled skill and driveas a surgeon. He was the man who had made liver transplantationa reality when many had insisted it could not be done. But now hefelt chronically fatigued. He was becoming careful instead of bold,he would later reflect in his 1992 memoir, The Puzzle People. Andhe privately wondered whether this drug was better left to someoneelse to champion or reject.ILLUSTRATION | JACOB THOMAS AT DECO ZONEFALL 2006 19