The History of Heart Transplants

Heart transplantation proceeded from the development of cardiosurgery as well as the success of other organ transplants. The patients who underwent the first heart transplants had a high fatality rate, but the development of a better medication to prevent rejection led to heart transplantation becoming an acceptable form of treatment. The need for donor hearts has inspired the invention and use of artificial hearts for transplantation.

Development of Heart Surgery

• Heart surgery developed during World War II when Dwight Harken, an Army surgeon, created a method to remove shrapnel from the hearts of wounded soldiers. His method did not involve stopping the heart, but his success inspired other forms of minor cardiosurgery. More complex heart problems required stopping the heart, but a person could live for four minutes without blood pumping through his veins. Bill Bigelow, a doctor at the University of Minnesota, came up with the idea of cooling the body, which would give surgeons a window of 10 minutes in which the patient could survive without the heart pumping blood. This allowed the first open-heart surgery in 1952. The success of that surgery stimulated further advances in cardiosurgery.

The First Heart Transplants

• The first heart transplants followed upon both the development of cardiosurgery and the first successful kidney transplant in 1963. The first heart transplant, which used a heart from a chimpanzee, occurred in 1964, but was a failure. Christian Barnard, a cardiothoracic surgeon in Cape Town, South Africa, performed the first heart transplant from a human donor in 1967. His patient died 18 days after the operation because his body rejected the transplant.

Difficulties

• Barnard and other doctors continued to try heart transplantation, but rejection and infection dogged their efforts. According to Lawrence Cohn, 99 heart transplants took place in the year after Barnard's first attempt, but the difficulties and high mortality rate persuaded most to give up the practice. Furthermore, public fears erupted during the 1960s over how donor organs, including hearts, would be obtained; the worry was that accident victims who were organ donors would have their deaths hurried along.

Resurgence of Heart Transplants

• The development of cyclosporin, a medicine made from a Norwegian fungus with immunosuppressive properties, led to a resurgence of heart transplants in the 1980s. Cyclosporin prevented the body from rejecting the organ transplants without completely destroying the immune system. This led to a precipitous drop in the mortality rate as doctors had more control over infection while also being able to prevent rejection.

The Invention of Artificial Hearts

• The availablity of donor hearts has been a concern since heart transplantation began, and so researchers have explored the possibility of transplanting artificial hearts. An American, Denton Cooley, first transplanted an artificial heart made of plastic into a patient awaiting a donor heart in 1969. The artificial heart worked for the three days the patient had to wait, but was showing signs of failure by the time it was replaced. Robert Jarvik, at the University of Utah, led a team in the development of an artificial heart for permanent use. Jarvik's team transplanted their device into a patient in 1982; he lived for four months. The results encouraged others to pursue the invention of artificial hearts while Jarvik continued to revise his design. The greatest accomplishment in the use of artificial hearts came in 2000 when Jarvik's latest design was transplanted into a 61-year-old patient. That patient lived for seven years with the artificial heart, motivating further research into and development of artificial hearts.