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©Los Angeles Times
© St. Petersburg Times, published September 3, 2001
Dr. Christiaan Barnard, the South African cardiologist who performed the world's first heart transplant, died Sunday at age 78.
Barnard suffered a fatal asthma attack after a morning swim at a resort in the coastal town of Paphos, Cyprus, where he often vacationed.
Barnard stunned the world on Dec. 3, 1967, when he transplanted the heart of a young woman who had died in an automobile accident into Louis Washkansky, a 53-year-old businessman whose heart was failing rapidly.
Washkansky lived only 18 days before his body rejected the heart. But that he stayed alive at all made Barnard an international celebrity and led to more transplants throughout the world.
Barnard's second patient, who received a transplant four weeks after Washkansky, survived for 18 months. His longest-lived patient, Dirk van Zyl, survived for 23 years before dying from complications associated with diabetes in 1996.
Today, an estimated 2,400 patients undergo heart transplants every year in the United States alone -- a number limited only by a lack of donors. About 87 percent of them survive for at least one year after the surgery and 75 percent for at least five years.
Barnard did not introduce any surgical techniques in his procedure, nor did he identify any drugs to block rejection.
His special contribution, according to Dr. Hillel Laks of the University of California at Los Angeles Medical Center, was having the courage to perform the procedure in the face of stiff questioning by some researchers.
"He reasoned that if people were clearly going to die, you were justified in starting a (transplant) trial even when you don't have all the answers," Laks said. "Because he started, other investigators were spurred to work to find answers to the problems. The speed of progress would have been far slower if not for the clinical trials begun by Chris Barnard."
In addition to his transplant work, Barnard developed a mitral valve for use in heart surgery and was the first to explain how atresia -- lack of development of the bowels -- occurs in newborns.
A man who never shied from controversy in apartheid-era South Africa, Barnard ignored many racial barriers in the country. He was the first doctor to use mixed-race nurses in the operating room to treat white patients and he transplanted the heart of a white woman into a black man.
Former South African president Nelson Mandela praised him as "one of our main achievers."
Barnard's life was transformed by celebrity. Immediately after Washkansky's transplant, the surgeon's face was on the cover of news magazines around the world, and he was flying first class to the United States to appear on television news shows.
Tall and handsome, the Afrikaans surgeon, son of a church pastor from the backwater town of Beaufort West, hobnobbed with popes, presidents, movie stars and other celebrities. He had trysts with Sophia Loren and Gina Lollobrigida. He was "consumed and intoxicated" by fame, he wrote in his 1993 autobiography.
But the celebrity took its toll. His first wife, Aletta, who had worked as a nurse to support him in his early years, divorced him after discovering a love letter from Lollobrigida. He subsequently married twice more, but was single at his death. He had five children.
By 1973, Barnard's team had performed 10 heart transplants, but he was discouraged by the failure rate. He began thinking along different lines when the son of a patient whose donor heart failed to start asked why the patient's original heart could not be re-implanted.
Intrigued, Barnard began implanting the donor heart without removing the original, leaving the patient with two functioning hearts. He performed 49 such transplants between 1975 and 1984, with a 50 percent one-year survival and 20 percent five-year survival. Several of these patients lived for more than 10 years.
But immune suppression improved, particularly with the introduction of cyclosporin in 1982. Barnard reverted to his original transplant procedure and the field began to flourish once more.
Barnard performed 75 heart transplants and his team did more than 150. After crippling arthritis forced him to retire from surgery in 1983, he wrote a distinguished cardiology text, several lesser nonfiction books about cardiology, a scandalous autobiography and four novels. He spent his last years consulting, giving lectures and operating his farm in South Africa.