On December 3, 1967, Louis Washkansky, 55, got a new heart - and the world a sensation: The first heart transplant was successful. Washkansky survived 18 days with the organ of 25-year-old Denise Darvall, who was killed in a car accident. A lot of doctors and helpers at Groote Schuur Hospital in Cape Town, South Africa, contributed to this medical success. To world fame, however, came only one: Christiaan Barnard, the head of the medical team. The first surgeon to succeed in a heart transplant.
Barnard had learned a lot from cardiologist Norman Shumway of Stanford, California. Shumway and his colleague Richard Lower had done the preliminary work for Barnard's pioneering work at Stanford; For the first time in the fifties, they had been able to produce a heart transfer from dog to dog. Shumway himself performed his first human heart transplant just a month after Barnard, in January 1968. One could say one month late. His patient survived 15 days, 3 days less than Washkansky.
Soon, four decades later, only experts know Shumway and Lower. After Barnard is asked in quiz shows. The winner takes it all.
Heart surgery is now facing such a breakthrough again. This time, it's about finding a solution to the blatant lack of human organs. Pigs should help. And baboons.
Baboons survive between 26 and 96 days
Bruno Reichart, director of the Cardiac Surgery Department at Klinikum Großhadern of the University of Munich, and Christopher McGregor of the Mayo Clinic in Rochester, Minnesota are working to ensure that pig hearts can be transplanted into humans in the near future. The pump of these animals resembles the human in anatomy and size. In three or four years, it is said, initial trials could begin on patients. So far, the operation is practiced on baboons. In Munich, the monkeys survive with the graft for up to 26 days. In Rochester, survival varies between 60 and 96 days, depending on whether the pig's heart replaces the original organ or is inserted into the abdomen.
McGregor leads the race, which he and his Munich colleague do not want to call racing. Shumway did not want that at the time either.
The goal is a successful xenotransplantation (from xenos, Greek for "the stranger"). The tempting idea: instead of desperately waiting for donor hearts, one could simply produce as many hearts as needed. Pigs can be easily reared, become sexually mature after only half a year, and after only four months of gestation throw eight young on average. A huge problem would be solved.
In Germany alone, 900 people were waiting for a new heart last year, and only about one in three received a donor organ. So far, there are two ways to get out of the waiting list: life-saving organ donation or death. Artificial hearts are not a long-term alternative so far. Every year, up to 30 percent of patients die on the waiting list because they do not receive a transplant on time. Anyone finding a solution here will go down in history as the next great cardiac surgeon.
The immune system is still rebelling
But nature does not participate yet. It is the old problem with rejection: the immune system rebels against the foreign organ. Through years of research, physicians and pharmaceutical companies have developed drugs to suppress the body's immune response to a foreign heart, lung, liver or kidney. But these are exclusively organs of human donors. The path until the human body accepts an animal organ is still far.
"If a baboon whose heart has been replaced by a pig's heart survives on average for three months, we can start clinical trials on humans," says McGregor. "I guess that's going to happen in 2010 or 2011." So far, proteins on the surface of pig hearts have caused rejection in baboons, says McGregor. "It's about reducing these surface substances by genetic modifications so much that no antibody reaction takes place," explains his colleague Reichart.