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CyprusEducationYears active1950–2001Known forfirst successful human-to-human heart transplantRelativesMedical careerProfessionInstitutionsUniversity of MinnesotaSub-specialtiesChristiaan Neethling Barnard (8 November 1922 – 2 September 2001) was a South African who performed the world's first highly publicized heart transplant and the first one in which the patient regained consciousness. On 3 December 1967, Barnard transplanted the heart of accident-victim into the chest of 54-year-old, with Washkansky regaining full consciousness and being able to easily talk with his wife, before dying 18 days later of pneumonia. The anti-rejection drugs that suppressed his immune system were a major contributing factor.
Barnard had told Mr. Washkansky that the operation had an 80% chance of success, a claim which has been criticised as misleading. Barnard's second transplant patient, whose operation was performed at the beginning of 1968, lived for a year and a half and was able to go home from the hospital.Born in, Barnard studied medicine and practised for several years in his native South Africa. As a young doctor experimenting on dogs, Barnard developed a remedy for the infant defect of.
His technique saved the lives of ten babies in Cape Town and was adopted by surgeons in Britain and the United States. In 1955, he travelled to the United States and was initially assigned further gastrointestinal work.
He was introduced to the heart-lung machine, and Barnard was allowed to transfer to the service run by open heart surgery pioneer. Upon returning to South Africa in 1958, Barnard was appointed head of the Department of Experimental Surgery at the Groote Schuur Hospital, Cape Town.He retired as Head of the Department of Cardiothoracic Surgery in Cape Town in 1983 after developing in his hands which ended his surgical career. He became interested in anti-aging research, and in 1986 his reputation suffered when he promoted, an expensive 'anti-aging' skin cream, whose approval was withdrawn by the United States soon thereafter. During his remaining years, he established the, dedicated to helping underprivileged children throughout the world. He died in 2001 at the age of 78 after an asthma attack. Contents.Early life Barnard grew up in,.
His father, Adam Barnard, was a minister in the. One of his four brothers, Abraham, was a 'blue baby' who died of a heart problem at the age of three (Barnard would later guess that it was ). The family also experienced the loss of a daughter who was stillborn and who had been the fraternal twin of Barnard's older brother Johannes, who was twelve years older than Chris.
Barnard matriculated from the Beaufort West High School in 1940, and went to study medicine at the, where he obtained his in 1945.His father served as a missionary to mixed-race peoples. His mother, the former Maria Elisabeth de Swart, instilled in the surviving brothers the belief that they could do anything they set their minds to. Career Barnard did his and at the in, after which he worked as a general practitioner in, a rural town in the Cape Province. In 1951, he returned to Cape Town where he worked at the City Hospital as a Senior Resident Medical Officer, and in the Department of Medicine at the Groote Schuur Hospital as a registrar. He completed his master's degree, receiving Master of Medicine in 1953 from the University of Cape Town. In the same year he obtained a doctorate in medicine (MD) from the same university for a dissertation titled 'The treatment of tuberculous meningitis'.Soon after qualifying as a doctor, Barnard performed experiments on dogs investigating intestinal atresia, a birth defect which allows life-threatening gaps to develop in the intestines. He followed a medical hunch that this was caused by inadequate blood flow to the fetus.
After nine months and forty-three attempts, Barnard was able to reproduce this condition in a fetus puppy by tying off some of the blood supply to a puppy's intestines and then placing the animal back in the womb, after which it was born some two weeks later, with the condition of intestinal atresia. He was also able to cure the condition by removing the piece of intestine with inadequate blood supply. The mistake of previous surgeons had been attempting to reconnect ends of intestine which themselves still had inadequate blood supply. To be successful, it was typically necessary to remove between 15 and 20 centimeters of intestine (6 to 8 inches). Jannie Louw used this innovation in a clinical setting, and Barnard's method saved the lives of ten babies in Cape Town. This technique was also adapted by surgeons in Britain and the US.
In addition, Barnard analyzed 259 cases of tubercular meningitis.Owen Wangensteen in Minnesota had been impressed by the work of Alan Thal, a young South African doctor working in Minnesota. He asked Groote Schuur Head of Medicine John Brock if he might recommend any similarly talented South Africans and Brock recommended Barnard. In December 1955, Barnard travelled to the, United States, to begin a two-year scholarship under Chief of Surgery Wangensteen, who assigned Barnard more work on the intestines, which Barnard accepted even though he wanted to move onto something new. Simply by luck, whenever Barnard needed a break from this work, he could wander across the hall and talk with who ran the lab for open-heart surgery pioneer. Gott had begun to develop a technique of running blood backwards through the veins of the heart so Lillehei could more easily operate on the aortic valve (McRae writes, 'It was the type of inspired thinking that entranced Barnard'). In March 1956, Gott asked Barnard to help him run the heart-lung machine for an operation.
Shortly thereafter, Wangensteen agreed to let Barnard switch to Lillehei's service. It was during this time that Barnard first became acquainted with fellow future heart transplantation surgeon. Barnard also became friendly with Gil Campbell who had demonstrated that a dog's lung could be used to oxygenate blood during open-heart surgery. (The year before Barnard arrived, Lillehei and Campbell had used this procedure for twenty minutes during surgery on a 13-year-old boy with ventricular septal defect, and the boy had made a full recovery.) Barnard and Campbell met regularly for early breakfast. In 1958, Barnard received a Master of Science in Surgery for a thesis titled 'The – problems in the fabrication and testing of a prosthetic valve'. The same year he was awarded a Ph.D.
For his dissertation titled 'The aetiology of congenital intestinal '. Barnard described the two years he spent in the United States as 'the most fascinating time in my life.' Upon returning to South Africa in 1958, Barnard was appointed head of the Department of Experimental Surgery at Groote Schuur hospital, as well as holding a joint post at the University of Cape Town. He was promoted to full-time lecturer and Director of Surgical Research at the University of Cape Town. In 1960, he flew to Moscow in order to meet, a top expert on (later he credited Demikhov's accomplishment saying that 'if there is a father of heart and lung transplantation then Demikhov certainly deserves this title.' ) In 1961 he was appointed Head of the Division of Cardiothoracic Surgery at the teaching hospitals of the University of Cape Town. He rose to the position of Associate Professor in the Department of Surgery at the University of Cape Town in 1962.
Barnard's younger brother, who also studied medicine, eventually became Barnard's right-hand man at the department of Cardiac Surgery. Over time, Barnard became known as a brilliant surgeon with many contributions to the treatment of cardiac diseases, such as the. He was promoted to Professor of Surgical Science in the Department of Surgery at the University of Cape Town in 1972. In 1981, Barnard became a founding member of the. Among the many awards he received over the years, he was named in 1984.Historical context Following the first successful in 1953, in the United States, Barnard performed the second kidney transplant in South Africa in October 1967, the first being done in Johannesburg the previous year. On 23 January 1964, at the in, performed the world's first and world's first cardiac by transplanting the heart of a chimpanzee into a desperately ill and dying man.
This heart did beat in the patient's chest for approximately 60 to 90 minutes. The patient, died without ever regaining consciousness.Barnard had experimentally transplanted forty-eight hearts into dogs, which was about a fifth the number that had performed at Maimonides Medical Center in New York and about a sixth the number had performed at Stanford University in California.
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Barnard had no dogs which had survived longer than ten days, unlike Kantrowitz and Shumway who had had dogs survive for more than a year.With the availability of new breakthroughs introduced by several pioneers, also including at the Medical College of Virginia, several surgical teams were in a position to prepare for a human heart transplant. Barnard had a patient willing to undergo the procedure, but as with other surgeons, he needed a suitable donor.During the era in South Africa, non-white persons and citizens were not given equal opportunities in the medical professions. At, was an informally taught surgeon.
He started out as a gardener and cleaner. One day he was asked to help out with an experiment on a giraffe. From this modest beginning, Naki became principal lab technician and taught hundreds of surgeons, and assisted with Barnard's organ transplant program. Barnard said, 'Hamilton Naki had better technical skills than I did. He was a better craftsman than me, especially when it came to stitching, and had very good hands in the theatre'. A popular myth, propagated principally by a widely documentary film called Hidden Heart and an erroneous, maintains incorrectly that was present during the Washkansky transplant. First human-to-human heart transplant Barnard performed the world's first human-to-human heart transplant operation in the early morning hours of Sunday 3 December 1967., a 54-year-old grocer who was suffering from and incurable, was the patient.
Barnard was assisted by his brother Marius Barnard, as well as a team of thirty staff members. The operation lasted approximately five hours.Barnard stated to Washkansky and his wife Ann Washkansky that the transplant had an 80% chance of success. This has been criticised by the ethicists and as making claims for chances of success to the patient and family which were 'unfounded' and 'misleading'.Barnard later wrote, '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.' The donor heart came from a young woman, who had been rendered brain dead in an accident on 2 December 1967, while crossing a street in Cape Town. On examination at Groote Schuur hospital, Darvall had two serious fractures in her skull, with no electrical activity in her brain detected, and no sign of pain when ice water was poured into her ear.
Coert Venter and Bertie Bosman requested permission from Darvall's father for Denise's heart to be used in the transplant attempt. The afternoon before his first transplant, Barnard dozed at his home while listening to music.
When he awoke, he decided to modify Shumway and Lower's technique. Instead of cutting straight across the back of the atrial chambers of the donor heart, he would avoid damage to the septum and instead cut two small holes for the venae cavae and pulmonary veins.
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Prior to the transplant, rather than wait for Darvall's heart to stop beating, at his brother Marius Barnard's urging, Christiaan had injected potassium into her heart to paralyse it and render her technically dead by the whole-body standard. Twenty years later, Marius Barnard recounted, 'Chris stood there for a few moments, watching, then stood back and said, 'It works.' 'Washkansky survived the operation and lived for 18 days, having succumbed to as he was taking.Additional heart transplants Barnard and his patient received worldwide publicity. As a 2017 BBC retrospective article describes, 'Journalists and film crews flooded into Cape Town's Groote Schuur Hospital, soon making Barnard and Washkansky household names.' Barnard himself was described as 'charismatic' and 'photogenic.' And the operation was initially reported as 'successful' even though Washkansky only lived a further 18 days.Worldwide, approximately 100 transplants were performed by various doctors during 1968.
However, only a third of these patients lived longer than three months. Many medical centers stopped performing transplants. In fact, a U.S. Publication states, 'Within several years, only Shumway's team at Stanford was attempting transplants.' Barnard's second transplant operation was conducted on 2 January 1968, and the patient, survived for 19 months. Blaiberg's heart was donated by Clive Haupt, a 24-year-old black man who suffered a stroke, inciting controversy (especially in the African-American press) during the time of South African apartheid. Dirk van Zyl, who received a new heart in 1971, was the longest-lived recipient, surviving over 23 years.Between December 1967 and November 1974 at Groote Schuur Hospital in Cape Town, South Africa, ten heart transplants were performed, as well as a heart and lung transplant in 1971.
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Of these ten patients, four lived longer than 18 months, with two of these four becoming long-term survivors. One patient lived for over thirteen years and another for over twenty-four years.Full recovery of donor heart function often takes place over hours or days, during which time considerable damage can occur. Other deaths to patients can occur from preexisting conditions. For example, in pulmonary hypertension the patient's right ventricle has often adapted to the higher pressure over time and, although diseased and hypertrophied, is often capable of maintaining circulation to the lungs. Barnard designed the idea of the heterotopic (or 'piggy back' transplant) in which the patient's diseased heart is left in place while the donor heart is added, essentially forming a 'double heart'. Barnard performed the first such heart transplant in 1974.From November 1974 through December 1983, 49 consecutive heterotopic heart transplants on 43 patients were performed at Groote Schuur. The survival rate for patients at one year was over 60%, as compared to less than 40% with standard transplants, and the survival rate at five years was over 36% as compared to less than 20% with standard transplants.Many surgeons gave up cardiac transplantation due to poor results, often due to by the patient's immune system.
Barnard persisted until the advent of, an effective immunosuppressive drug, which helped revive the operation throughout the world. He also attempted in a human patient, while attempting to save the life of a girl who was unable to leave artificial life support after her second aortic valve replacement.Public life. Christiaan Barnard in Italy in 1968Barnard was an outspoken opponent of South Africa's laws of apartheid, and was not afraid to criticise his nation's government, although he had to temper his remarks to some extent to travel abroad. Rather than leaving his homeland, he used his fame to campaign for a change in the law.
Christiaan's brother, went into politics, and was elected to the from.