How it began
On December 3, 1967, surgeon Christiaan Barnard and his team at Groote Schuur Hospital in Cape Town transplanted the heart of Denise Darvall, a 25-year-old woman fatally injured in a road accident, into Louis Washkansky, a 53-year-old man dying of chronic heart disease. Her father, Edward Darvall, agreed to the donation of her heart and kidneys. Surgery began shortly after midnight, and just before 6 a.m. the new heart was electrically shocked into action.
Before it existed
By late 1967 Washkansky had suffered several heart attacks that had almost totally incapacitated his heart muscle. According to the University of Cape Town account, Professor Velva Schrire, who led the hospital's cardiologists, recognized that the surgical techniques then in use could not help all forms of severe heart failure. The transplant technique itself had been developed by American researchers in the 1950s, and Norman Shumway had achieved a successful heart transplant in a dog at Stanford University in 1958.
How it works
The failing heart is removed and replaced with a heart taken from a donor who has been declared brain dead, while a heart-lung machine keeps the patient alive. In Cape Town the work drew on many disciplines: cardiologists, radiologists, pathologists, immunologists who assessed whether the donor heart would be rejected, anesthetists, theater and intensive care nurses, heart-lung machine technologists and the blood transfusion service. After surgery the patient receives drugs that suppress the immune system so the body does not reject the new heart.
What changed first
Washkansky regained consciousness and his new heart functioned normally, but the drugs given to suppress his immune system left him open to infection. He died of double pneumonia 18 days after the operation. The event focused international attention on Groote Schuur Hospital and on the abilities of its staff.
Where it stands today
In the 1970s the development of better anti-rejection drugs made transplantation more viable. Barnard continued to perform heart transplants, and by the late 1970s many of his patients were living up to five years with their new hearts. Heart transplant surgery continues to be performed successfully, although finding appropriate donors remains extremely difficult. The University of Cape Town division where the operation took place now carries the name Chris Barnard Division of Cardiothoracic Surgery.
