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 end-stage 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 implanted. For the heart,

this is optimally less than six hours. 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!