Last updated: December 26, 2020
Throughout most of history, the heart has been regarded as the seat of human emotion and, consequently, considered to be sacred. Now, human anatomy is much better understood and even though we know that the heart is not the center of emotions, it is however affected by them, alongside stress and many other factors. Nevertheless, the heart is an organ like any other and when some organs, including the heart, fail beyond medical treatment, there is an option to surgically replace them with healthy organs from donors. This is known as transplantation.
Many brilliant and ingenious doctors and surgeons have added their names to the annals of heart transplant history. Doctors such as Dwight Harken, Norman Shumway, and Christiaan Barnard have dedicated their lives to understanding this incredible organ. Their contribution to the knowledge and practice of heart surgery has changed the outcome for many people with end-stage heart failure.
Due to the complexity of factors involved in performing a successful heart surgery, it was only performed in a handful of cases prior to the Second World War. During the war, Dwight Harken, who was a military surgeon at the time, performed many surgeries on wounded soldiers to remove shrapnel from their hearts. As a testament to his skill, there were no fatalities, and heart surgery came to be regarded as a reliable option.
Even though the surgeries themselves were often successful, early approaches to postoperative care were inadequate and responsible for many deaths within the first few months of a procedure. Harken and Shumway were key figures in the development of cardiothoracic surgical and postsurgical care.
The concept of organ and tissue transplant has been explored for centuries. Organs have been taken from cadavers as well as animals for research. In the early 1900s, animal veins and arteries were used by surgeons to practice suturing and vascular anastomosis. Doctors and surgeons experimented on animals to hone their skills so that they would have a better chance of performing a heart surgery on a person. Norman Shumway and Richard Lower perfected their technique in dogs for many years before trying a human-to-human heart transplant.
Animals have also been used as donors for hearts and other organs. A well-known instance is when Baby Fae received a baboon heart in 1984. Efforts at such procedures have mostly been futile due to tissue incompatibility and the limitations of immunosuppressant therapy.
Christiaan Barnard successfully performed the first ever human heart transplant in 1967 on a patient with end-stage heart failure, using another human heart. The patient did not live very long. However, the surgery itself was a success and he made heart transplant history. Dr. Barnard used the techniques that were developed by Norman Shumway of Stanford University. A year later in the US, Dr. Shumway performed the first adult human-to-human heart transplant in 1968.
Today, new approaches to heart transplant and heart health are being researched. Scientists, doctors, and engineers are organizing efforts to create effective artificial hearts and ventricular assist devices (VADs) for transplant candidates either as a long-term solution or as a short-term bridge until they can find a donor. Artificial hearts have become imperative due to the rising number of patients who require a transplant as the supply of donated hearts has not increased accordingly. If patients have the opportunity to benefit from such devices, they will readily do so to improve the quality and span of their lives.
For more information regarding heart transplant surgery programs, as well as cardiothoracic associations, check these resources:
See also our page on heart anatomy and an introduction to cardiology for further information.