Making Organ Transplants Possible
There are several mentions of heart transplantation in ancient
mythology and biblical reference, but it was the pioneering work of
Alexis Carrel at the beginning of the 20th century that made organ
transplants a real possibility.
The next reported heart transplantations were those of Mann at the
Mayo Clinic in 1933. These dog heart transplants were able to function
until the onset of rejection at eight days.
After these experiments, there was a 20-year period without progress
until the late 1940s. S.V.P. Demikhov, a Russian surgeon, then
initiated a series of ingenious experiments on the technical
feasibility of both intra thoracic heart transplants as well as heart
lung transplantation, although his work was not reported in the West
With the advent of techniques for successful heart surgery in the
1950s, major attention was finally given to heart transplantation.
Various experiments using either hypothermia (low temperature) and
circulatory arrest or the early cardiopulmonary bypass machines
permitted a number of ingenious laboratory studies to be performed.
The currently-used surgical technique for heart transplantation
originated with the work of Lower & Shumway in 1959, but the first
human heart transplantation was performed by Christian Barnard in Cape
town, South Africa, in December 1967.
This transplant triggered a great amount of interest at other centres
around the world, with 170 transplants by 65 surgical teams performed
between December 1967 and March 1971. However, with only 15 per cent
of patients surviving a year after the procedure, enthusiasm for heart
transplantation waned by the end of 1971.
Widespread application of heart transplantation depended on
development of better immunosuppressive therapy. This came with the
discovery of the drug Cyclosporin.
The rapid development and introduction of this compound to clinical
transplantation resulted in superior results. Later on many drugs and
methods were used in heart transplantation, including FK506, ATG,
OKT3, MMS and body radiation.
In 1964, Hardy and colleagues performed the first chimpanzee-to-human
heart transplantation. However the transplanted heart was unable...