The Star Malaysia

Behind the drama of the world’s first heart transplant

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Cape Town: It was an operation that earned him acclaim, but the world’s first heart transplant also provoked hate mail and outspoken criticism of South African surgeon Christiaan Barnard, 50 years ago.

“We did not realise that it would take the public by storm and create such an outcry,” says Dene Friedmann, a specialist nurse on the cardiovasc­ular team, standing in the same Cape Town operating theatre where the medical feat took place.

“There were people who wrote quite critical letters to Professor Barnard, horrible letters calling him ‘the butcher’,” says Friedmann, now in her 70s.

The insults rained.

“I have heard of human vultures, but it is the first time I have seen one with a name on it,” said one letter dated just one month after the operation and sent from Illinois in the United States.

“You had the audacity to assume the authority of God by pretending to become the giver of life,” said another from Hong Kong.

The French magazine Paris Match summed up the ethical debate in a headline: “The battle of the heart. Do surgeons have the right?”

But the scientific community welcomed the technical advance – the United States had also been seeking the accolade – and ordinary citizens sent congratula­tions.

At the time, the heart was not considered a mere organ – it was more a symbol of deeper meaning, for some, the bringer and taker of life itself.

There was also a political dimension, with South Africa’s apartheid government delighted to have some good news.

“They used Professor Barnard as the ambassador for the country,” recalls Friedmann.

It was on the first floor of Groote Schuur Hospital on Dec 3, 1967 that Louis Washkansky received the donor heart of Denise Darvall, the 25-year-old victim of a road acci- dent. Darvall’s father had agreed to the procedure.

In the operating theatre, Friedmann leaned in to assess Washkansky on the table.

“I looked into this empty chest with no heart in it, a man lying there without a heart in his body and just a lung heart machine keeping him alive. It was very scary,” she says.

In the room next door, Barnard ordered that Darvall’s ventilator be turned off. After about 12 minutes her heart stopped beating and it was quickly moved to the theatre where 53-year-old Washkansky awaited it.

“There were still a lot of medical ethics issues. It was the first time that a heart transplant was being done... and he did not want anybody to be able to say we took out a beating heart from a patient,” Friedmann says of Barnard, who died in 2001.

“There was a feeling of nervousnes­s: is this heart going to beat and take over the circulatio­n? When it started, it was so wonderful.”

Barnard, then 45, said of the operation: “The heart lay paralysed, without any sign of life. We waited – it seemed like hours – until it slowly began to relax. Then it came like a bolt of light.

“There was a sudden contractio­n of the atria, followed quickly by the ventricles in obedient response. Little by little, it began to roll with the lovely rhythm of life.”

During the apartheid years, race became a considerat­ion when selecting a donor, but only to avoid allegation­s of prejudice. The pioneering operation could have been performed weeks earlier, when a coloured man’s heart became available.

“Professor Barnard had decided that the first donor had to be a white person, because of the apart- heid. We did not want anyone to say: ‘You are taking out a black person’s heart to put it in a white patient,’” says Friedmann.

She also squashed the rumour that persists about a black South African, Hamilton Naki, participat­ing in the first transplant but that he was deprived by the apartheid government of any recognitio­n.

“He was very talented, but he never operated on patients,” says Friedmann, who worked with Naki on many laboratory tests on dogs.

Just 18 days after the world first heard of the Washkansky operation, the patient died. The autopsy revealed that his lungs gave out, but not the heart, because his immune system had collapsed, resulting in pneumonia.

Today, a heart transplant – while still a high-risk procedure – no longer makes headlines. Around 3,500 transplant­s are carried out each year.

 ?? — AFP ?? No ordinary feat: Prof Barnard showing the radiograph­y of Washkansky at the Groote Schuur Hospital in Cape Town.
— AFP No ordinary feat: Prof Barnard showing the radiograph­y of Washkansky at the Groote Schuur Hospital in Cape Town.
 ?? — AFP ?? Match made in surgery: File photos of transplant recipient Washkansky (left) and donor Darvall.
— AFP Match made in surgery: File photos of transplant recipient Washkansky (left) and donor Darvall.

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