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Heart Transplantation
A Brief Summary by Nikolett Jakab
Christiaan Neethling Barnard, born on November 8, 1922 in South
Africa, was the first doctor ever performing a successful heart
transplantation on a human.
Before that, Barnard experiented on dogs
When on December 1967, a woman, injured fatally in an automobile accident
died. Her heart was in good condition and perfect for a donor.
Louis Washkansky with identical blood
type as the woman needed a heart
donor. Washkansky suffered from
diabetes and dangerous heart diseas.
He knew that either way with or
without surgery, he can die, and so
Barnard got a permission from
Washkansky to perform a heart
transplantation on him.
Later on, Barnard referred to Washkansky's bravery as "For a dying man it
is not a difficult decision because he knows he is at the end. If a lion
chases you to the bank of a river filled with crocodiles, you will leap into the
water convinced you have a chance to swim to the other side. But you
would never accept such odds if there were no lion."
Washkansky survived the surgery with his new heart for 18 days, then died from
double pneumonia as a result of his suppressed immune system.
(Double pneumonia is the infection of both lungs caused by bacterias or viruses.)
But still to perform a successful heart surgery meant a step
further in healthcare, the improvement in medications, and
Barnard became celebrated around the world for his daring
accomplishment.
In 1968, he went to the surgery
room again and performed his
second heart transplantation. His
patient survived nineteen months. It
was a progress rushing through the
world like wild fire.
Every year in the United States there
are about 4,000 people who could
benefit from a heart transplant.
Unfortunately, there are only about
2,000 donor hearts available.
After heart transplant, five year survival averages about 50%60%. One year survival averages about 85%-90%.
But what is heart transplantation?
Heart transplantation is a surgery performed on patients with endstage heart failure or severe coronary artery disease.
It’s either done by having the patient’s heart removed and getting a different
one instead (orthotopic procedure) or left in place to support the donor heart
(heterotopic procedure).
Most patients require a transplant because their hearts can no
longer pump well enough to supply blood with oxygen and nutrients
to the organs of the body. A smaller number of patients have a
good pump, but a bad "electrical conduction system" of the heart.
This electrical system determines the rate, rhythm and sequence
of contraction of the heart muscle.
Donors are people with “brain death” or irreversible brain injury
who still has other healthy organs. A team of physicians, nurses,
and technicians goes to the hospital of the donor to remove
donated organs once brain death of the donor has been
determined.
The removed organs are transported on ice to keep them alive until they can be
six hours
implanted. For the heart, this is optimally less than
. So, the organs
are often flown by airplane or helicopter to the recipient's hospital.
Sometimes, our immune system detects the newly transplanted
organs as enemies and so starts to destroy is.
It is when the organ gets rejected but can be controlled with powerful
immunosuppressive medications. If there is not enough
immunosuppression, the organ can reject acutely
Even when an organ
is available, it
happens to be no
individual it could
work with.
And for many reasons, individuals and
families refuse to donate organs that could
save a life.
Other times, there is no
way to get the heart to a
suitable recipient in time
for the organ to still be
viable.
Maybe one day, technology will be advanced enough to
create working donors.
Until then, we are here to support.
Sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1121917/
http://www.medicinenet.com/heart_transplant/index.htm
http://www.pbs.org/wgbh/aso/databank/entries/bmbarn.html
http://www.nndb.com/people/887/000082641/
Thank you for your time!