Weekend Argus (Saturday Edition)
Historic transplant proudly remembered
It’s 50 years since Chris Barnard won hearts and headlines, writes MICHAEL MORRIS
FIFTY years ago this week, Chris Barnard’s surgical team at Groote Schuur Hospital ushered in a new era of medicine. Transplanting a human heart was in the popular mind a staggering frontier of medical science when, in December 1967, a chronically ailing grocer from Green Point went under the knife at Cape Town’s premier hospital.
One even has a sense that for the young Beaufort West-born surgeon who led the team in this historic operation, there was something uncanny and barely conceivable about a procedure that had never been tried before.
“I looked down and saw this empty space,” said Professor Chris Barnard only hours afterwards, “… the realisation that there was a man lying in front of me without a heart but still alive was, I think, the most awe-inspiring moment of all.”
Not unsurprisingly, the breakthrough earned Barnard fame and adoration around the globe in early December 1967, and altered the trajectory of medical science.
Green Point grocer Louis Washkansky, 55, was told he had only weeks to live if he did not get a new heart, and was fully apprised of the risks. In those early days, these were immense. And though the operation was a success, Washkansky lived for only 18 days before succumbing to pneumonia.
But his new heart, it is said, beat strongly to the end.
The post-operative drama of those 18 days is captured in the report of December 4, 1967, reproduced below.
There were, in fact, two organ transplants on that first weekend of December. The heart of bank clerk Denise Ann Darvall, 25, – fatally injured when she and her mother (who was killed) were knocked down by a car in Main Road, Observatory on the Saturday afternoon – was given to Washkansky at Groote Schuur in a five-hour operation that ended at 1am on Sunday morning.
One of her kidneys went to 10-year-old Jonathan van Wyk in the second such operation in the city, at the Karl Bremer Hospital.
The heart transplant was the bigger news by far, and spurred rapid advances in clinical organ transplantation.
The second heart transplant in the world was performed only three days later by Dr Adrian Kantrowitz in the US. In this operation, the recipient was a baby – but the infant lived for only six hours.
Yet within a year, no fewer than 100 hearts had been transplanted around the world.
Barnard told journalists that the ground-breaking procedure was preceded by three years of research “in the animal laboratory”, where former gardener and noted laboratory assistant Hamilton Naki gained attention for his skills as a surgical assistant (though he did not take part in the heart transplant op).
The operation on Washkansky was conducted by a team of about 30 people, of whom Barnard remarked: “Everybody helped to make this a success.”
Two decades later, a telling and distinctly South African footnote was added to the historic op of 1967.
On December 16, 1987, readers learned that a potential donor for the world’s first heart transplant was rejected because the donor was black.
“From cradle to grave” was the phrase popularly used to express the span of apartheid’s influence, but even in death apartheid was immutable.
Professor Barnard disclosed in 1987 that the operation on December 3, 1967 could have been performed two weeks earlier when the first donor was available.
In an article, “Reflections on the First Heart Transplant”, published in the South African Medical Journal, Professor Barnard said the “possibly controversial” decision was made before the operation.
He said: “In my surgical unit in Cape Town, all patients, regardless of ethnic background, were treated equally.
“Cardiologist Professor (Velva) Schrire believed that selection of a non-white recipient or donor might be misinterpreted by the political critics of South Africa. I therefore agreed that both recipient and donor should be Caucasian.
“If we had not decided on this policy, the first heart transplant could have been performed some two weeks earlier, when a black potential donor became available.”
The following is one of the main reports after the transplant.
December 4, 1967
Battle is on to keep patient alive
Prof Chris Barnard, the 44-yearold heart surgeon who carried out the world’s first successful heart transplantation in Groote Schuur Hospital yesterday, said today: “Our main job now is the battle to keep this man alive.”
Professor Barnard, an internationally recognised expert in the field of open-heart surgery, was too busy today to speak to reporters on his historic achievement.
He was at the hospital from early yesterday until late in the afternoon and returned again in the evening to see Mr Louis Washkansky. He was back there soon after 7am today.
The professor, the father of Springbok waterskier Deidre Barnard, told a reporter yesterday: “I thought we could succeed this far. The operation went off very well and I am very happy.”
Thirty-two hours after his historic heart transplant, Mr Louis Washkansky is maintaining his satisfactory condition. Dr JG Burger, medical superintendent of the hospital, said this afternoon that the 55-year-old patient’s condition was unchanged since this morning.
The critical part in the heart transplantation would be in about a week’s time, Professor JH Louw, head of the Department of Surgery at the University of Cape Town Medical School, said today.
“The unknown part will come then,” he said. “We do not know how his body will react to the new heart.
“The body tends to reject foreign tissues. We are giving him drugs to suppress the rejection of foreign tissue, but this also suppresses his defence against infection.”
Mr Washkansky’s condition was, however, better than they had expected. His temperature, pulse rate, and blood pressure were all those of a normal person.
Professor Louw described his present condition as “first class”.
Describing the battle to keep Mr Washkansky alive during the critical stages after the operation, Professor Louw said a trained nurse and a trained surgeon were always in the ward.