Heart transplants are common today, and recognized as life-saving procedures. So why did we almost give up on them in the 1970s?
If you look up Norman Shumway online, you'd be forgiven for thinking that he had performed the first heart transplant. So many articles call him a "pioneer," and stress his place as the "first" heart transplant surgeon – but he wasn't. He was the first doctor to do a heart transplant, from an adult donor to an adult recipient, in the United States.
The first transplants were done between dogs. They all died after only a few hours. The first transplant involving a human happened in 1964 - doctors implanted a chimpanzee heart into a human. The heart beat, but the patient died an hour later when his body rejected the heart. In 1967, an adult to adult heart transplant took place in South Africa. The patient died eighteen days later of pneumonia. The first American human to human surgery also took place in 1967. The patient died six hours later. South Africa tried again in 1968, and counted it a success that the patient lived for a few months. Shumway performed his surgery in 1968, and the patient died after fifteen days.
Although one patient in 1969 survived the surgery and lived for another twenty years, by the 1970s, few doctors were interested in doing heart transplants anymore. They were risky procedures that required massive amounts of post-operative care, and it was considered unusually successful if the patient lived for months afterwards. Time did a story on the fact that the procedure was dying out. Shumway persisted, feeling his way along, trying to find ways of making transplants more successful. He worked both the medical and social angle, developing ways of biopsying hearts to make sure they were appropriate for the patients, while encouraging a wider range of people to become heart donors. He developed procedures to take care of patients after the operation (today heart transplant post-operative procedure involves a personal nurse and multiple daily blood tests).
Shumway's big breakthrough, though, came in the 1980s, when his team was the first to use cyclosporine for heart transplants. The body's immune system is meant to attack outside agents, including new organs. Cyclosporine is an effective immunosuppressant, helping a patient get through the delicate time after surgery. Suddenly, a heart transplant became something a person could live through. As the rate of success climbed, more people began doing the procedure, and today about 2,000 are performed every year in the US. It's strange to think how close the procedure came to dying out. So often, in science, credit goes to the person who first thinks things up. It's interesting to see someone get credit for persistence, instead of precedence.
Image: US Navy