First Heart Transplant: Dec. 3, 1967
A 45-year-old South African surgeon who is a relative unknown in the world of cardiology begins an operation that will transform the treatment of heart disease and make him into an international celebrity.
Shortly after midnight, Dr. Christiaan Barnard, heading a team of 20 doctors, removes the heart from the body of a young woman named Denise Darvall–who had been hit by a car–and places it into a 53-year-old grocer, Louis Washkansky, who was dying of heart disease.
Barnard would say that he wasn’t sure the surgery was successful until five hours later, when he electrically shocked the transplanted heart and it started beating. Washkansky was soon able to speak and even walk a bit, but died only 18 days after the operation when he developed double pneumonia–a consequence of having his immune system suppressed so that his body wouldn’t reject the new organ.
A month later, Barnard repeated the procedure on a 58-year-old dentist named Philip Blaiberg, giving him the heart of a young black man, Clive Haupt, who had died of a stroke–a very controversial decision in racially segregated South Africa, Blaiberg was kept in a sealed suite of hospital rooms for more than two months and was not given steroids–treatment that had weakened Washkansky. He managed to live for 19 months.
Other doctors had performed heart transplants on animals, but none had been willing to do the surgery on humans, in part because of legal issues, particularly in the United States, where district attorneys had threatened to prosecute doctors who took organs from people who were brain dead, but had not yet died.
Barnard’s surgery, however, made it more acceptable to use organs from brain-dead patients. He had been able to take advantage of the absence of legal restraints in South Africa; in fact, he had gone ahead with the operation without seeking permission of his hospital’s executives. He only told them about it afterwards.
To his surprise, Barnard became an instant celebrity and was featured on magazine covers around the world. He embraced his fame and a jet set lifestyle and soon divorced his wife of 21 years and married the teenage daughter of a multimillionaire.
He also became an outspoken critic of South Africa’s apartheid policy and challenged its racial barriers by allowing mixed-race nurses to treat white patients in the operating room and transplanting the heart of a white woman into a black man.
Barnard continued doing heart transplants, but other doctors became more reluctant because so many of the patients didn’t survive as a result of their bodies rejecting the transplanted organ. That began to change in 1974 when a researcher in Norway discovered a new drug called cyclosporine, which reduced a body’s level of rejection. Heart transplant patients were soon able to live longer after the surgery, typically at least two more years.
Barnard, who had suffered from rheumatoid arthritis for much of his life, was forced to end his career as a surgeon in 1983. He turned to writing books, from medical texts to four novels–including a thriller about organ transplants–to two autobiographies. Even though his medical career ended, Barnard still relished public attention. He told an interviewer: “Any man who says he doesn’t like applause and recognition is either a fool or a liar.”
As he grew older, Barnard became obsessed with anti-aging treatments and conducted research into injecting animal embryo cells into older people with the hope that that could restore body functions. He himself had several of the treatments.
He also made a lot of money endorsing an expensive anti-aging skin cream called Glycel. But after the U.S. Food and Drug Administration demanded proof that Glycel was effective, the cream was pulled from the market. Barnard’s endorsement badly tarnished his medical reputation and he later called it one of the regrets of his life.
Barnard died in 2001 after suffering an asthma attack while swimming during a vacation in Cyprus. Today, almost 3,500 of the operation he pioneered are performed worldwide every year. The average length of survival after surgery is now 15 years.
More slices of history
Scientists reverse chronic pain in mice
In a new animal study, scientists from St. Louis University say they may have found a way to prevent and even reverse chronic pain.
Previous studies have focused on a drug called adenosine, which has been shown to be effective in treating pain, but has also been shown to activate unknown pathways in the body, which can cause severe side effects.
In the new study, the researchers aimed to identify the specific pathway linked to the pain-relieving effects of adenosine. They analyzed more than 300 rodents that had chronic neuropathic pain, or pain resulting from nerve damage.
The researchers found that they could use a small adenosine molecule to activate a receptor in the brain called A3. Activation of the A3 receptor, researchers found, seemed to stop or reverse chronic pain in the rodents. In addition, they found that the A3 activation did not alter the reward center of the rodents’ brains, suggesting that the practice would be unlikely to lead to addictive behaviors.
The study’s findings, published in the journal Brain, suggest that the A3 receptor pathway needs to be studied further with the goal of developing more effective treatments for chronic pain.
Breast cancer vaccine shows promise
A new vaccine may be effective in slowing the progression of breast cancer, even in patients where the disease has reached an advanced state.
The vaccine under study was developed by scientists from the Washington University School of Medicine in St. Louis, and works by targeting a protein (mammaglobin-A) that is found in high levels in breast tumor cells.
In the new study, which was a phase 1 trial, the researchers tested the vaccine on 14 patients with metastatic breast cancer, or cancer that had already spread to other parts of the body. They found that the vaccine was safe to use and led to fewer side effects, when compared with many pre-existing breast cancer treatments and excluded any severe and life-threatening effects.
The researchers also found that about 50 percent of the patients who received the vaccine showed no cancer progression after one year. In comparison, in the control group of patients who did not receive the vaccine, about one-fifth showed no cancer progression after one year.
The results of of the study, published in Clinical Cancer Research, suggest that the vaccine could be a safe and effective way to improve survival rates in metastatic breast cancer patients. The findings are significant in that patients with metastatic breast cancer often have weakened immune systems and have a more challenging time receiving effective treatment, researchers said.
The researchers are now planning a larger clinical trial to study the effects of the new vaccine on newly-diagnosed breast cancer patients.
Even without concussions, football may change brain
A new study has found that playing football for one season may be enough to cause signs of mild traumatic brain injury, even if a player hasn’t suffered any concussions.
Scientists at Wake Forest Baptist Medical Center in North Carolina studied 24 football players between ages 16 and 18. The players underwent brain scans both at the start and the end of the football season.
The researchers found that at the end of the season, the football players had slight changes in their white matter–the part of the brain responsible for communication. In addition, the players who experienced more frequent and more severe hits were more likely to experience such changes, the researchers said.
The study’s findings, presented to the Radiological Society of North America, suggest that just one season of football may be enough to cause abnormal brain changes, which researchers said were similar to the effects of traumatic brain injury. The scientists said that the findings are of particular concern for young people who play contact sports, as head impacts may affect the development of their brains.
The researchers said they next plan to study the age at which young brains are most vulnerable, as part of an effort to make football and other contact sports safer.