Successful heart transplantation depends on both scientific expertise and serendipity. The right recipient must be paired with the right donor at the right time and place.
In the fall of 1967, Dr. Norman Shumway of the Stanford University School of Medicine was ready.
Serendipity was not.
The road to this pivotal moment had been long and emotional. Heart transplantation experiments began in 1933 at the Mayo Clinic in Rochester, Minn. After a 10-year lull, World War II forced advances in repairing hearts shredded on the battlefield. With that, the long-held notion that the human heart was far too delicate to operate on faded.
In the early 1950s, doctors discovered they could use hypothermia to lower the body's temperature and temporarily stop the heart to work on it. Later, the heart-lung machine, which kept those organs functioning during an operation, opened new surgical vistas.
But there were more than technical obstacles to overcome in the pursuit of heart transplantation. Before the 1960s, public opinion held that the heart sheltered an individual's soul. It was only after the invention of the heart-lung machine that the heart came to be viewed for what it is--a muscular pump.
Shumway had spent eight years perfecting heart transplants on dogs before he announced, on Nov. 21, 1967, that he would attempt to transplant a heart as soon as a donor and recipient could be matched. The ideal donor, he advised, would be a young person dying of causes unrelated to heart disease. The recipient would be someone who could not withstand the rigors of traditional heart surgery.
On Dec. 3, less than two weeks after Shumway's headline-making announcement, the world was stunned by news that South African surgeon Christiaan Barnard had transplanted the heart of a 23-year-old auto accident victim into the chest of a middle-aged man.
The recipient, Louis Washkansky, lived only 18 days--no surprise, considering that there were few options available then to keep the body from rejecting the foreign heart tissue.
Nevertheless, Barnard, a handsome and flamboyant man who had used surgical techniques that Shumway had painstakingly developed, instantly became famous.
One month after Barnard's historic feat, serendipity blessed Shumway when a 54-year-old man with a severely diseased heart received the heart of a 43-year-old woman who had suffered a massive brain hemorrhage. America's first heart transplant might have occurred even sooner--about a week after Barnard's--except that the family of a potential donor refused to give up the organ for transplantation.
