Upon celebrating 50 years since the first heart transplant one has to wonder at the bravery and daring of Dr. Christiaan Neethling Barnard and his team that performed this operation on 3 December 1967.
Doctors and veterinary surgeons had been experimenting on transplanting different organs in animals for many years. Body parts such as kidneys had been successfully transplanted into humans but many surgeons were afraid to take the risky step of transplanting a heart until there was a guarantee of absolute success.
It has to be conceded that the road to the transplant was paved by the work of medical pioneers whose discoveries in medicine made the transplant possible. Anaesthetics, X Rays, antiseptics, immunosuppression, analgesics, antibiotics, and advanced technology were some of the innumerable non-human factors that made the operation possible. But the final one step required for the first transplant required immense courage, vision and pragmatism. The quote attributed to Dr. Chris Barnard attests to the above: ‘It is infinitely better to transplant a heart than to bury it to be devoured by worms.’
Christiaan Neethling Barnard was born in the Karroo in the Cape Province on 08 November 1922. His father was a minister of the Dutch Reformed Church. Although many say, the young Chris did not particularly display much intellect he was highly disciplined, focused and curious; qualities that enabled him to qualify as a medical doctor and to become a specialist at a young age. Incidentally, Dr. Barnard was not the only medical doctor in the family, his younger brother Marius was part of his original transplant team!
In 1956 he started postgraduate training on surgery of the intestines under Dr Owen H. Wangensteen at the University of Minnesota, USA after receiving a scholarship. He later joined Walt Lillehei’s, the pioneer in open heart surgery.
Dr. Barnard returned to South Africa and joined Groote Schuur Hospital in Cape Town as cardiothoracic surgeon in 1958. Subsequently, he established the hospital’s first heart unit. He shortly became full-time lecturer and Director of Surgical Research at the University of Cape Town and then the Head of the Division of Cardiothoracic Surgery. By 1961 he was Associate Professor in the Department of Surgery at the University of Cape Town.
Although Dr. Barnard received a lot of attention and adulation and even became an international celebrity after the transplant, he never stopped work on refining techniques and on experimenting with new ones. Notwithstanding a high failure rate after the initial transplant leading to much disappointment, Dr. Barnard was not discouraged instead he worked on improving the post-transplant prognosis. He improved the postoperative regimen and devised a new technique in 1974. In this heterotopic technique, or piggyback technique, the donor heart is added to the patient’s diseased heart. It proved to be more viable with his longest surviving patient living for 23 years thereafter.
The heart transplant was just the beginning and it is heartening to know that lifesaving work on treating heart patients continues and the legacy of the original team continues.
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