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Transplant surgery

Human heart from Robert Moss, who received a heart transplant in August 2000

Human heart from Robert Moss, who received a heart transplant in August 2000

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The journey of a transplanted organ

Transplant surgery is dramatic, complex and fast. The clock starts ticking as soon as an organ is removed from a still-living body, placed carefully in a special cold container and then transported at speed to the seriously ill patient waiting for the replacement organ. Some organs are transported many miles by ambulance, or even by helicopter, as the organ will start to deteriorate unless it is transplanted quickly.

Early transplantation attempts from 1908

Surgeons have been experimenting with transplantation techniques for many years. Alexis Carrel came up with a method to transplant organs as early as 1908, but many of his experiments failed as organs transplanted from one animal to another were eventually rejected.

New drugs lead to successful transplants from the 1950s

The first successful transplant - of a kidney - occurred in 1953. The organ was not rejected because donor and recipient were identical twins and therefore genetically identical. However, new drugs such as cortisone, which appeared in the 1950s, and ciclosporin, which arrived on the scene in the late 1970s, were developed to lessen the problem of rejection. Combinations of drugs are now used to prevent rejection in transplant patients.

Christiaan Barnard and successful heart transplantation in 1967

The most famous transplant surgery occurred in South Africa in 1967 when Christiaan Barnard carried out the first heart transplant. The patient, Louis Washkansky, lived for 18 days with the heart of a 25-year-old woman beating inside him. This may now seem like a short time, but it was a major breakthrough. So extraordinary was this event that it was celebrated the world over. Yet by 1984 the procedure had become almost commonplace and even children were receiving heart transplants.

Replacement surgery - implants

Implants are mechanical body parts that are inserted by orthopaedic surgeons when the original parts have worn out, a process which is known as replacement surgery. Often they take the place of joints that have worn out due to age or disease.

The development of transplantation from the 1950s to the present day

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In the second half of the 1900s, the options for transplant surgery continued to grow. Artificial hearts have been with us since the 1950s. Since the late 1970s it has been possible to offer some deaf people the chance to hear with the aid of cochlear implants. In 1981 the first successful heart-lung transplant was performed in Stanford. Despite this, replacement surgery remains a highly technical and very specialised profession. Its success also depends on the availability of suitable organ donations, and in many places in the world there are not enough to meet the demand. This can raise serious ethical questions and, some fear, lead to the body being treated as a commodity.

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Bibliography

J Anderson, F Neary and J Pickstone, Surgeons, Manufacturers and Patients: A Transatlantic History of Hip Replacement (Basingstoke: Palgrave, 2007)

C Barnaard, One Life (Cape Town: Harold Timmins, 1969)

R Calne, `History of Transplantation', The Lancet, 368 (December 2006), pp 551-552

K Jeffrey, Machines in Our Hearts: The Cardiac Pacemaker, The Implantable Defibrillator and American Health Care, (Baltimore: John Hopkins, 2001)

D Joralemon, `Organ Wars: The Battle for Body Parts', Medical Anthropology Quarterly, 9/3 (September 1995), pp 335-356

Novels and Patient Experiences:

A Kelley, The Bower Bird (Luath Press, 2007)

T Stark, Knife to the Heart: The Story of Transplant Surgery (London: Macmillan, 1996)

Glossary:

Transplant

Surgical operation to introduce organ or tissue from one person (the donor) to another (the recipient). It may also refer to the transfer of tissues from one part of a person's body to another part of the same person's body.