Michael Shanks - site 2006: Hearts: History

"A new heart also will I give you, and a new spirit will I put within you: and I will take away the stony heart out of your flesh, and I will give you a heart of flesh." -Ezekiel 36:26, Holy Bible, King James Version

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Christian Barnard performing the first human heart transplant in 1967

The concept of heart transplantation has existed since biblical times, yet it is generally regarded as a relatively new phenomenon. The first human heart was transplanted in 1967, when Christiaan Barnard implanted a donor heart into Louis Washansky. The transplant lasted 18 days before Mr. Washansky died of infectious complications, but a huge psychological barrier had been crossed in both the medical field and the mind of the public: "what until then had seemed only a fantastic theory - that the life of one human being could be fully maintained by a heart transplant from another human being - had finally become an established fact" (Frazier 6). Excitement about the possibilities of heart transplantation sparked a transplant "boom" in the 1980's that tried to help or cure problems ranging from birth defects to cancer to diabetes. Over the next 12 months, surgeons performed 102 transplants in 17 countries, though many of these surgeries were fraught with complications due to immunological rejection and infection (Reed 9).

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Baby Fae after her surgery

Another famous surgery in the history of heart transplantation is the case of Baby Fae, a newborn infant who received a heart implant from a 7-month-old baboon. She died twenty days after the implant, due to her immunological attack on the graft. The case raised many ethical issues in the field of transplantation, since the "doctors ... never sought a human heart and the chances for a successful xenograft were very slim" (Hubbard 385). It seemed, then, that the doctors only attempted the surgery to make the press as the first xenotransplantation in history.

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Diagram of Liotta heart

Due to the shortage of eligible organ donors, and the risks involved in xenotransplantation, researchers soon looked for total artificial hearts to help patients with heart problems. In 1969, the Liotta heart was used to circulate blood in a patient for three days until another heart was made available, thus introducing the idea of artificial hearts as a “bridge” to donor heart transplantation. The console system that powered the air-driven heart was about the size of a standard washing machine (THI).

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Barney Clark with Dr. William DeVries after surgery

In 1982, the Jarvik-7 was implanted into Barney Clark, marking it the first total artificial heart transplant that was designed to be permanent. The heart pumped according to Barney's needs for 112 days, and the control module could be used to alter the heart rate, the pressure of compressed air, and the percentage of each beat in systole (Cauwels 178).

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Robert Tools with Dr. Robert Dowling after surgery

Most recently, in 2001, Robert Tools was the first patient to receive the AbioCor, a total artificial heart that was the culmination of 30 years of research and design. Robert survived for five months with the AbioCor before dying of abdominal bleeding. The AbioCor has made history as the first artificial heart without a permanent external console system or tubes or wires penetrating the skin. Thus patients have the freedom to move around freely with the implant and have more of a semblance of a normal life.

References

Cauwels, JM. The Body Shop: Bionic Revolutions in Medicine. St. Louis: Mosby, 1986.
Frazier, OH. Support and replacement of the failing heart. Philadelphia: Lippincott-Raven, 1996.
Hubbard, LL. "The Baby Fae Case," Medicine & Law 6(5): 385-96, 1987.
Reed, A. Solid Organ Transplantation. New York: Kluwer, 2001.
Texas Heart Institute. Liotta Total Artificial Heart. http://www.tmc.edu/thi/liotta.html

Ten Things 2006: Projects > Tammy Wang: A New Heart to Heart > Hearts: Let's Begin!