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Last Updated: Friday, 18 June, 2004, 04:39 GMT 05:39 UK
Heart transplants: 25 years on
By Ray Dunne
BBC News Online health staff

It is 25 years since the first successful heart transplant was carried out in the UK. BBC News Online looks back on this medical milestone.

Gordon MacDonald
Gordon underwent surgery in 1979
Gordon MacDonald is one of the UK's longest surviving heart transplant patient.

He underwent surgery in 1979. His heart was failing and he was critically ill.

"Life was very difficult," he says. "I was only 40 years old. I had young children. I had everything to live for.

"But I was very ill. My life was ebbing away."

Doctors offered Gordon a heart transplant. It was a gamble. There was no guarantee it would save his life.

The procedure had only been carried out on a small number of patients around the world, with mixed results.

Gordon jumped at the chance. "I was absolutely delighted," he says.

The surgery, which was carried out at Papworth Hospital in Cambridgeshire, was a success.

"I felt fantastically well after the transplant," he says.

"I started to do things that I hadn't done for a long time, such as walking, cycling and swimming.

"My life changed from that day. It changed in every way."

British pioneer

The operation was carried out by Sir Terrence English. He had spent most of the 1970s in the United States, where he developed the skills needed to carry out such a complex procedure.

On his return to Britain, Sir Terrence faced some opposition to his plans to carry out heart transplants.

There was a lot of pressure on us to succeed
Sir Terrence English
"There were a lot of difficulties," he says. "We didn't have approval from the Department of Health to carry out heart transplants.

"We had tacit approval from the local health authority, which agreed to fund two operations. There was a lot of pressure on us to succeed."

The first patient died before he could have the transplant. However, subsequent attempts proved more successful.

"We were very relieved," says the now-retired surgeon.

Over 1,000 people have since gone on to have a heart transplant at Papworth.

Sir Terrence and his colleagues went on to achieve even greater things.

In 1984, they carried out Europe's first successful heart-lung transplant.

The following year, they performed the world's first heart, lung and liver transplant.

Ten years ago, they carried out the world's first operation to give a man a "bionic" heart - a battery-operated heart known as a ventricular assist device.

World first

The first heart transplant was carried out by Christian Barnard in South Africa in 1967.

He transplanted the heart of a road accident victim into a 59 year-old-man, called Louis Washkansky, in Cape Town's Groote Schuur Hospital.

We did not think it was a great event
Christian Barnard after carrying out the world's first heart transplant in 1967
Mr Washkansky died 18 days later after contracting pneumonia.

The powerful drugs he was taking to stop his body from rejecting the heart had reduced his ability to fight off the infection.

Nevertheless, the operation marked a milestone in medicine - even if Mr Barnard did not see it that way.

Speaking after the operation, he played down the importance of what he had just done.

"We did not think it was a great event and there was no special feeling. I was happy when I saw the heart beating again.

"We did not stand up or cheer or something like that. I didn't even inform the hospital authorities that I was going to do the operation."

However, others did see it as a great event. Today, thousands of people have heart transplants every year.

To date, there have been 4,792 heart transplants in the UK. The operation has helped many to live full and healthy lives.

"The heart transplant really was an enormous technological advance," says Professor Jeremy Pearson, associate medical director of the British Heart Foundation.

"Having a transplant gives you at least 10 years of healthy life. For some people, its much longer."

Around 300 heart transplants are carried out in the UK each year. The figure could be much higher if more hearts were available.

Organ shortage

The fact is not enough people in the UK are willing to donate their organs after they die. It is something the government is trying to address.

"We know that 90% of the population support transplantation but only 19% have so far joined the NHS Organ Donor Register," says a spokeswoman for the Department of Health.

"We would urge people to discuss this issue with relatives and join the NHS Organ Donor Register."

In recent years, doctors and scientists have started to look at alternatives to live heart transplants.

"There is quite a lot of work going on," says Professor Pearson.

One of the big hopes is stem cell research. Recent studies have suggested that taking cells from bone marrow and injecting them directly into the heart can help it to repair.

However, much more research is needed before this technique could be offered to patients.

"It is not quite science fiction," says Professor Pearson. "But it is still many years away."

In the meantime, the focus is on getting more people to sign up to donate their hearts after they die.

"It is essential," says Gordon MacDonald. "It makes such a difference to people's lives. It's incredible.

"I am so indebted to the family who donated their relative's organ for my transplant. It has changed my life."

The BBC's Gill Higgins
"Now transplants are standard procedures and it is mechanical pumps that are grabbing attention"

Stem cells could repair hearts
26 Apr 04  |  Health
'Grow your own transplant organ'
18 Dec 03  |  Health
Artificial heart muscle tested
22 Aug 03  |  Health

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