Britain’s first heart transplant was carried out 50 years ago today in an operation lasting more than seven hours and involving a team of 18 doctors and nurses.
The world’s first human heart transplant has been performed just six months earlier at a hospital in Cape Town, South Africa, by pioneering cardiac surgeon Dr Christian Barnard. Although his patient died 18 days later from complications, the actual transplant procedure had been proven to work and in the following months several specialist heart hospitals around the globe trialled the new life-saving technique.
The UK’s first transplant – the 10th worldwide – was performed at the National Heart Hospital in Marylebone, London, where the team of surgeons was headed by South African-born surgeon Donald Ross. The recipient was a 45-year-old man who was not named at the time, but later revealed to be Frederick West, a married building contractor from Leigh-on-Sea, in Essex. The donor heart came from a 26-year-old labourer who suffered fatal head injuries in an accident at work.
Worldwide media interest in the pioneering new transplant surgery had been intense ever since the first one and when rumours began circulating of the UK operation a crowd of press reporters and photographers converged on The Heart Hospital. They were rewarded with a prepared statement read on the hospital steps just a few hours after the surgery was completed. The spokesman said of the operation: “It has gone uneventfully. The patient, as far as we know, is satisfactory.”
Later a full press conference was staged involving the surgeon, Mr Ross, and his entire team. He explained that although the entire procedure had taken more than seven hours from start to finish, the process of actually transplanting the donor heart lasted around two hours and had gone to plan. He said that while the patient was recovering well, the next 10 to 14 days would be critical in determining his response to the transplant.
Several major hospitals in and around London had been put on alert to notify the Heart Hospital if a donor heart became available, with the surgical team on constant standby. Although the donor was brain dead from his injuries, his heart was kept beating artificially inside his body, which was rushed by ambulance from King’s College Hospital, Lambeth, to the Marylebone operating theatre.
The procedure was controversial as it raised some serious ethical questions. Opponents asked how could the donor be declared dead if his hear was still beating? A later inquest proved beyond doubt that he could not possibly have survived his catastrophic head injuries.
In the days that followed, official photographs were released showing a smiling Mr West recovering from the operation and surrounded by members of the nursing team. He was also visited by Dr Barnard, who said he appeared to be making good progress. Sadly, there would be no happy ending.
In order for the body to accept the new heart, it had to be flooded with drugs to suppress its immune system, which would otherwise react against the new organ and reject it. But giving the drugs also lowered the body’s resistance to other infections and its ability to fight them. This is what led to the death of the first heart transplant patient in South Africa, and also claimed Mr West’s life.
He died 46 days after receiving his new heart and after contracting what the hospital called an “overwhelming infection”, which he had been fighting for nine days. He had also been suffering from kidney complications. In fact, of the more than 100 heart transplants carried out worldwide in 1968 using Dr Barnard’s technique, only a third of patients survived for longer than three months. The problem wasn’t the transplant, but the difficulties in getting the body to accept the donor heart.
It meant that surgeons now adopted a much more cautious approach, with far fewer heart transplants carried out over the following decade. Eventually, in the early 1980s, new drugs were developed which greatly improved the chances of long-term survival after a heart transplant. Today, around 3,500 heart transplants are performed annually, most of them in the USA, and the average post-operation survival period is 15 years, with some patients living far longer. Significant research is also being done into developing new artificial hearts for use in transplant surgery.