Slice of History: 1st 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.

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