One of earliest Starzl kidney transplant patients still active
September 17, 2012 4:00 AM
Sue Ellen Fitzsimmons
Bob Phillips (right), the longest-surviving kidney transplant recipient, with Dr. Thomas Starzl.
A 1964 photo of Bob Phillips in Dr. Starzl's laboratory.
By Mark Roth Pittsburgh Post-Gazette
When truck driver Bob Phillips tried to collect a payment for gasoline he had just delivered one night in 1962, his customer wouldn't give it to him because he thought Mr. Phillips was drunk.
But that wasn't why the 36-year-old Virginia man was weaving and slurring his words. Unbeknownst to him, his kidneys were failing. Fifty years ago, his illness, known by the tongue-twisting name of glomerulonephritis, was usually considered untreatable.
In fact, when he finally got a diagnosis a few days later, one hospital staffer told his wife to take him home and "find a good preacher" for his funeral.
Luckily for Mr. Phillips, his sister Ruth had other ideas. She had found a newspaper article about an experimental kidney transplant program at the University of Colorado, and soon he was on a plane to Denver to meet the young surgeon doing the risky operations, Thomas Starzl.
When they met, they realized they were born only a few months apart, and the close personal connection between the world-renowned surgeon and the former truck driver has remained to this day.
Last week, Dr. Starzl was named a co-winner of the prestigious Lasker Award for Clinical Medical Research for his pioneering work in organ transplants, which he'll receive Friday at a ceremony in New York. And Mr. Phillips, now retired at his home in Colonial Beach, Va., is the longest-surviving recipient of a genetically mismatched kidney in the world.
Dr. Starzl said in an interview last week that there may be some identical twin recipients who have survived slightly longer, but their cases are different because there was no "immunological barrier" that would cause them to reject the donated organ.
Even though Mr. Phillips got his kidney from his younger sister, they weren't even the same blood type. Despite that, except for one brief crisis a couple of weeks after the operation, his kidney continues to function well. He outlived his donor sister and his wife, and last year he traveled to Portugal to receive the Burl Osborne Pioneer Organ Replacement Hero Award from the International Federation for Artificial Organs.
Not only is the transplanted kidney working well, but Mr. Phillips has been completely free of anti-rejection medication for 18 years, Dr. Starzl said. In fact, of the six surviving kidney transplant patients Dr. Starzl operated on between 1962 and 1964 in Denver, all of them have stopped taking immunosuppressants.
That grew out of his finding in the 1990s that in many organ transplant recipients, cells from the donated organs had infiltrated tissues and organs throughout their bodies, a process he called microchimerism, allowing their bodies to recognize the transplanted organ as their own. Once microchimerism takes hold, he theorized, patients should be able to curtail or drop their anti-rejection medication, reducing the likelihood that they would get infectious diseases or cancer from having a depressed immune system.
Carefully testing that concept, Dr. Starzl helped those early kidney patients, including Mr. Phillips, wean themselves off their immunosuppressants.
The surgeon, who still has offices at UPMC but no longer does operations, said that because organ transplants have become so routine, people have forgotten how courageous the early patient volunteers were.
The early kidney, liver and heart transplant patients were heroes who "faced the great unknown in the early years and chose to run the uncharted gantlet of transplantation instead of giving up," he said.
Mr. Phillips said he never looked at himself as a hero. "Whether it was stupidity or ignorance, I didn't give [survival] a thought. I had a strong opinion that I was going to get out of the hospital and make it."
After his January 1963 operation, the new kidney worked pretty well for the first three weeks and then stopped making urine. Fluid built up in his abdomen and his weight soared.
Around that time, he recalled, a young woman was killed in an auto accident, and he was prepped for surgery to take out his kidney and put hers in. But then one of her parents refused to authorize the transplant, and he was taken back to his room, his hope dwindling.
Suddenly, in the middle of the night, his kidney began working, "and I called the nurse and said 'I need some more jugs.' " He released so much urine that his weight dropped from 143 to 108 pounds. Since then, his kidney has never malfunctioned.
After Mr. Phillips recovered, he wasn't able to get his old job back, and so for the next two years, he remained in Denver and worked in Dr. Starzl's lab, cleaning instruments and occasionally watching experimental surgery on dogs. At his one-year transplant anniversary, he told the physicians gathered around him in the lab that "I love you doctors like my brothers."
When he finally returned to the Washington, D.C., area, he worked at the front desk of a retirement home for the next 33 years. His wife, Bertha Mae, died in 2006, and for the six years preceding her death, he cared for her as she lapsed into dementia.
As for the burden of being a caretaker, he said in his understated way, "I didn't mind it."
His niece, Beverly Ange, helped organize his trip to Portugal last year to get the Osborne award, which recognized "his continuing contribution to progress in human organ replacement with his kidney transplant in January 1963."
Ms. Ange, who lives near him in Montross, Va., said that until that trip, she never realized her Uncle Bob, who had fought under Gen. George S. Patton in World War II, was a famous patient. "I took it for granted before, but I think of it now, and it really baffles my mind that anyone can live with a kidney with another blood type for so long. I'm totally amazed."
Over the decades, Mr. Phillips and Dr. Starzl have had a running joke that each would be the pallbearer at the other's funeral. Beneath the banter, though, is mutual gratitude. "These men and women who got the early transplants were plenty tough. They were great, and they still are," Dr. Starzl said.
Recently, Mr. Phillips went in for his regular kidney function test.
"The doctor called and said he couldn't find anything wrong with me, so he couldn't make any money off of me this year."