Friday, August 24, 2012

Christiaan Barnard: First Human Heart Transplant

Great Advances in Science

“On Saturday, I was a surgeon in South Africa, very little known.
On Monday, I was world renowned.”
Dr. Christiaan Barnard, heart surgeon

Christiaan Neethling Barnard [1922-2001], shown here in this June 1968 photo, says: “The prime goal is to alleviate suffering, and not to prolong life. And if your treatment does not alleviate suffering, but only prolongs life, that treatment should be stopped.”

The date is a memorable one, December 3, 1967, not notable for something bad that took place, which is often the case of why we remember tragic, unhappy events. In this case what took place was something remarkable and hopeful in bettering the human condition: the first successful human heart transplant. I remember reading about it in the newspaper as a ten-year-old.

One site dedicated to transplant surgery puts it:
This great feat was accomplished by the surgeon, Dr. Christiaan (Neethling) Barnard from South Africa who was the first person to perform a human heart transplant on December 3, 1967 in Cape Town, South Africa. It was done at Groote Schuur Hospital in Cape Town on Louis Washkansky, an ill South African grocer who would most certainly die without the transplant.
The heart donor was Denise Darvell, a 24-year-old Caucasian woman who had died in a car accident; a drunk driver had also killed her mother in the same incident. [Not as well known then was that Darvell also donated her kidneys to another person; in this case, 10-year-old Jonathan van Wyk, a black boy, which was both atypical and controversial during South Africa's apartheid era]. 

The heart recipient was Louis Washkansky, a 54-year-old grocer and Lithuanian Jew, who survived the nine-hour operation and lived for 18 days; he died of pneumonia, a result of taking immunosupressive drugs to increase the risk of acceptance of a donor heart. The first attempt is always the hardest, but scientists and doctors learn from it. As for the surgeon who performed the first successful human heart transplant, he became a recognized name, a fact to which I can I can attest. An entry in Wikipedia says:
Barnard became an international superstar overnight and was celebrated around the world for his daring accomplishment. He was quite photogenic, and enjoyed the media attention following the operation. Barnard continued to perform heart transplants. A transplant operation was conducted on 2 January 1968, and the patient, Philip Blaiberg, survived for 19 months. Dirk van Zyl, who received a new heart in 1971, was the longest-lived recipient, surviving over 23 years.[4]
Barnard performed ten orthotopic transplants (1967–1973). He was also the first to perform a heterotopic heart transplant, an operation that he himself devised. Forty-nine consecutive heterotopic heart transplants were performed in Cape Town between 1975 and 1984.
Each year, about 3,500 heart transplants are done worldwide; the largest number in the United States. Much of the success in survival rates are due to improvements in post-operative care, including better immunosuppressant drugs like cyclosporine. [You can also read about the history and the procedures involved in heart transplants here, here and here].

Barnard was also known as an outspoken critic of South Africa's apartheid regime, using his fame to campaign for changes in the nation's laws; even so, by dint of being a white male in South Africa, he was likely denied the Nobel Prize in Medicine, a distinction he deserved. Barnard married three times, and was divorced three times, having two children in each of the marriages. Barnard retired as Head of the Department of Cardiothoracic Surgery in Cape Town in 1983 after he could no longer conduct surgery— he had developed rheumatoid arthritis in his hands in 1956, and his condition worsened over the years.

He spent a good deal of time doing charitable work, helping poor children, particularly in his latter years during which he resided on a 32,000-acre sheep farm and game preserve in the Karroo region of South Africa where he grew up. This was in stark contrast to his early years growing up in poverty, raised by a rather poor Afrikaner preacher and his wife. Sometimes things even up when one dedicates himself to doing good. 

Christiaan Neethling Barnard died of a severe severe asthma attack, while on holiday, on September 2, 2001; he was 78.