The Medicine Chest

Items

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  The Heterotopic Hearts

  “On two occasions in 1977, when a patient’s left ventricle failed acutely after routine open-heart surgery and when no human donor organ was available, Barnard transplanted an animal heart heterotopically. On the first occasion, a baboon heart was transplanted, but this failed to support the circulation sufficiently, the patient dying some six hours after transplantation. In the second patient, a chimpanzee heart successfully maintained life until irreversible rejection occurred four days later, the recipient’s native heart having failed to recover during this period. Further attempts at xenotransplantation were abandoned and even now, more than 30 years later, xenotransplantation remains an elusive holy grail despite decades of research.” ​ Extract: Brink JG, Hassoulas J. The first human heart transplant and further advances in cardiac transplantation at Groote Schuur Hospital and the University of Cape Town. Cardiovasc J Afr. 2009; 20(1):31-5
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  Electrocardiograph of first heart transplant

  “The ventricular peaks would shoot up as in wild flight, and their intermediate planes would begin to jumble against one another like the sudden crashing of cars on a freight-train. The heart’s beautiful symmetry would then be reduced to an erratic green line of wild jerks until it entered the final isoelectric phase resembling a sawtooth – jagged lines of the heart seeking to rise like a dying bird, fluttering upward, only to fall once again onto its flat plane of death” (Barnard in Young 2002: 79-80).
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  Denise Darvall

  "During the first heart transplant a shift occurred in the heart of Denise Darvall, the young brain-dead car accident victim whose family had allowed her heart to be given up. In his account of the operation, Barnard writes how her heart’s life fluid returned from the lungs – how many million times had it happened? – but different this time, void of oxygen. How her heart would react, at first, as if meeting only a small inconvenience. Unaware of what was happening, it would simply pump more excitedly – expecting some relief. Yet this would never come, and it would fall back in the first wave of confusion and fatigue. Barnard equates Darvall's heart with a bird trying to take flight" (Liebenberg 2011: 107-108).