Christiaan Barnard was made famous on 3rd December 1967, when he performed first human to human heart transplant in Cape Town, South Africa. He was just 45 when he performed this first dare, and would repeat the feat in years to come. It was Barnard’s conviction and persistence that inspired many across the world to fast track heart transplants. Ironically this all happened, when South Africa was getting isolated across the world, due to its discriminatory apartheid policies.
The beginnings
Born in South Africa in the year 1922, he completed his undergraduate medical course in the year 1945, from University of Capetown. After a short stint as a rural general practitioner, he completed his residency in Medicine from Groote Schuur hospital in Cape Town. As a young physician, Barnard got interested in animal experimental research. As part of an experiment, he could induce intestinal atresia in fetal puppies, and surgically correct it by rejoining the intestine.
In 1955, on the recommendation of his head of the department, he traveled to Minnesota in US for a scholarship. While this scholarship was related to intestinal surgery, Barnard instead got interested in heart lung machine. It was located in a facility, just across the corridor, where Barnard found friends as well as inspiration. Thus, by 1958 he became part of the team, that was innovating cardiac surgeries. When he returned back to South Africa, he had also earned a Masters in Surgery and also obtained PhD on his work on intestinal atresia.
Run up to the first cardiac transplant
On his return, he continued his work on cardiac surgeries, as well as experimental heart transplants in dogs. Many teams were working on heart transplants, and in 1964 an American Surgeon James Hardy performed a first chimpanzee-to-human transplant. This patient survived only an hour. Meanwhile, by 1967 Barnard had done about fifty dog-transplants. He was also heading the division of experimental surgery in Cape Town.
By 1966, Louis Washkansky, aged 55 years had a failed heart. With no other treatments in sight, he was already admitted under care of Christiaan Barnard, and was primed about potential cardiac transplant, a procedure no-one had done in the world. Search for a donor was already in place, amongst those with a healthy heart, but a damaged brain (such as someone with a road traffic accident).
On 2nd December 1967, Denise Darvall a 25 year old girl was seriously injured in a car accident. Her mother had passed away in the same accident, and by nine in the night, multiple attempts to resuscitate her had failed. Her father, Edward Darvall agreed for donating his daughters heart, to save another life. Washkansky received her heart on 3 December 1967, after a six hour surgery, lasting from 1am in the morning till 7am. It was team of thirty surgeons, anesthetists, nurses and technicians led by Christiaan Barnard. Surgery was a success, as Louis recovered, became conscious and spoke to his family members. However he died 18 days later due to Penumonia.
The legacy lived on
Barnard became an overnight international celebrity. A New York Times article captured public sentiment with these words:
“The world was startled to learn that the human heart, traditional seat of the emotions, home of the soul, symbol of love and of St Valentine’s Day, could be transplanted from one person to another as though it were nothing more than a complicated piece of plumbing.”
Three days after the first, on 6th December 1967 Dr. Adrian Kantrowitz a surgeon in US performed the world’s second human heart transplant, on a baby. Next month, on On 2 January 1968, Barnard performed the third heart transplant in the world on the 59 year old Philip Blaiberg. Philip was a dentist and he survived for 19 months. His donor was 24-year-old Clive Haupt, a person of color. This led to an uproar in South Africa. The debate of racism led medical doctors to comment:
“The relief of suffering knows no colour bar… The heart is merely a blood-pumping machine and whether it comes from a white, black or coloured man – or a baboon or giraffe, for that matter – has no relevance to the issue of race relations in the political or ideological context.”
Barnard’s sixth patient Dirk van Zyl, who received a new heart in 1971, was the longest-lived recipient, surviving over 23 years. Barnard and his team persisted with heart transplants. From November 1974 through December 1983, team at Groote Schuur performed 49 transplants with much better success rate. Many of these were heterotopic transplants (donor heart was transplanted, without removing the recipient’s heart)
Barnard retired as Head of the Department of Cardiothoracic Surgery in Cape Town in 1983 after Rheumatoid arthritis disabled his surgical hand. He spent his subsequent life in Europe, devoted to his foundation, and anti-aging research. He left the world in 2001. By this time heart transplant, as well as immunosupressive medications had prolonged the survival.
“It helps a man immensely to be a bit of a hero-worshipper, and the stories of the lives of the masters of medicine do much to stimulate our ambitions and rouse our sympathies.” – Sir William Osler