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For weeks, and months, and even years, surgical teams at more than 20 medical centers around the world have been standing ready to make the first transplant of a heart from one human being to another. What they have been waiting for is the simultaneous arrival of two patients with compatible blood types—one doomed to die of some disease that has not involved his heart, and a second doomed to die of incurable, irreversible heart disease.
Last week, in two hospitals separated by almost 8,000 miles of Atlantic Ocean, the historic juxtaposition happened and the heart transplants were performed. The physicians who performed them thus reached the surgical equivalent of Mount Everest, followed automatically by the medical equivalent of the problem of how to get down—in other words, how to keep the patient and transplant alive.
In this, the team at Brooklyn's Maimonides Medical Center, headed by Dr. Adrian Kantrowitz, admitted "unequivocal failure." Their patient, a 19-day-old boy, died 6½ hours after he received a new heart. But the team of Dr. Christiaan Neethling Barnard, 44, which acted first at Cape Town, South Africa, had a more enduring success. Their patient, a 55-year-old man, was feeding himself and making small talk a week after his epochal surgery. At this time, as expected, there appeared the first signs of a tendency by his body to reject the transplant, but the doctors were confident that they could control this reaction.
"Go Ahead." The Cape Town drama began three months ago, when Louis Washkansky, a wholesale grocer, was admitted to suburban Groote Schuur Hospital with progressive heart failure. Because of two heart attacks, one seven years ago and the other two years ago, the burly patient's heart muscle was not getting enough blood through clogged and closed coronary arteries. He also had diabetes, for which he had been getting insulin. His liver was enlarged. Surgeon Barnard's cardiologist colleagues gave "Washy" (as he was known to World War II buddies in North Africa and Italy) only a few months to live. They shortened it to weeks as his body became edematous (swollen with retained water). Washkansky was dying, and knew it.
Denise Ann Darvall, 25, had no thought of death when she set out with her father and mother to visit friends for Saturday-afternoon tea. In Cape Town's Observatory district, Edward Darvall stopped the car. His wife and daughter started across the street to a bakery to buy a cake when both were struck by a speeding car. Mrs. Darvall was killed instantly. Denise was barely alive, but only barely, on arrival at Groote Schuur Hospital. Her head and brain were almost completely destroyed. The emergency room called Dr. Barnard. The doctors agreed: Denise could not survive. Barnard took Darvall aside and explained what he wanted—the gift of a heart, unprecedented in history. Edward Darvall listened numbly as Barnard told him: "We have done our best, and there is nothing more that can be done to help your daughter. There is no hope for her. You can do us and humanity a great favor if you will let us transplant your daughter's heart." Said Darvall: "If there's no hope for her, then try to save this man's life." He signed the consent.