Context
By the 1960s, surgeons had mastered most organ operations except replacing the heart, the organ that defines life itself. The technical challenges were immense: the heart had to be stopped, the patient kept alive on a heart-lung machine, the donor heart connected to the recipient's blood vessels, and then restarted. And even if surgery succeeded, the immune system would attack the foreign organ.
The Deed
On December 3, 1967, Barnard and a team of 30 operated for nine hours to transplant the heart of Denise Darvall, a 25-year-old killed in a car accident, into Louis Washkansky, a 54-year-old grocer with terminal heart disease. The new heart started beating immediately. Washkansky survived 18 days before pneumonia, exacerbated by immunosuppressive drugs, killed him. Barnard's second patient, Philip Blaiberg, survived 19 months, proving the concept viable.
Why It Matters
The operation proved that the heart was not mystically special; it was a pump that could be replaced. It catalyzed the entire field of organ transplantation: kidneys, livers, lungs, and eventually faces and hands. The development of cyclosporine in the 1980s solved the rejection problem, making transplants routine. Over 150,000 organ transplants are performed annually worldwide.
Brutal Truth
Barnard operated in apartheid South Africa. His surgical team was multiracial, but the country's brutal racial system shaped everything around them. The ethics of the first transplants were questionable by modern standards: informed consent was minimal, and the rush to be 'first' drove decision-making. Barnard became a celebrity while his brother Marius, who assisted, received little credit.
By the Numbers
- 9 hours for the first transplant operation
- 18 days Washkansky survived
- 150,000+ organ transplants performed annually worldwide
- Cyclosporine (1983) improved 1-year survival from 40% to 80%