16 TIME December 11, 2017
1967 1977 1987
Year transplants were performedSurvival post-surgery1997 2007 201605(^10) YEARS
KIDNEY LIVER
Transplants
per year
People on
waiting list
7,
14,
19,
97,
The Brief
ON DEC. 3, 1967, A SOUTH AFRICAN SURGEON
named Dr. Christiaan Barnard opened a man’s
rib cage, took out his failing heart and replaced
it with a healthy one from a brain-dead woman
who had been hooked up to a ventilator. The pro-
cedure took eight hours and a team of 19 medical
professionals—and when the donor heart began
beating in its new body, the news ricocheted
around the world. Barnard became a star over-
night. “It captured people,” says Donald McRae,
author ofEvery Second Counts, which chronicles
the history of the first heart transplant. But all
was not well behind the
hospital doors.
Shortly after the land-
mark surgery, the patient,
a 53-year-old grocer named
Louis Washkansky, fell ill.
Barnard assumed the man’s
body was attacking the
heart—a common reaction
to organ transplants—so he
administered an aggressive
drug regimen to shut down
his immune system.
But the doctor was mis-
taken. It turned out Wash-
kansky had pneumonia, and
because he was given an immune-suppressing
cocktail, his body could not fight the infection.
Washkansky died 18 days after his surgery.
Transplant success has come a long way since
then. Today in the U.S., around 30,000 people
receive vital organs each year, and about 1 in 10 of
them get a heart. Still, more than 116,000 people
currently await donor organs—all of which are
in short supply. Twenty people die each day
waiting for a vital organ. At the same time, more
than half of all heart recipients go on to live
more than 13 years, and survival rates are always
ticking upward. That’s thanks to years of medical
advancement, ever better antirejection drugs and
the existence of a national system that matches
patients to donors.
There’s more reason to be hopeful: animal or-
gans and artificial hearts are helping to treat wait-
list patients, while other new technologies can
revive some hearts that had stopped beating for
an extended time. These scientific advances may
one day eliminate waitlists altogether.
MEDICINE
50 years on,
new hearts still
don’t come easy
By Emily Barone
△
The first successful
heart transplant
was an international
sensation
50 years
of progress
Heart transplants
have gotten safer
over time. Here’s
how long people
typically live
post-operation:
Transplants by
the numbers
HOW IT’S
DONE
SOURCES:EVERY SECOND COUNTS BY DONALD MCRAE; JOHNS HOPKINS MEDICINE; UNIVERSITY OF ROCHESTER MEDICAL
CENTER; ISHLT; NIH; CDC; SRTR; UNOS; HRSA; HISTORICAL AND CONTEMPORARY NEWS REPORTS; SYNCARDIA; TRANSMEDICS
Blood isdiverted
from the heart to
a bypass machine
tomaintain
circulation
during surgery
1
The failing heart
isremoved.
The donor heart
isstitched to
the recipient’s
blood vessels
2
The patient is
eased off the
bypass machine,
and blood is
redirected to
the new heart
3
The new heart
is sometimes
shocked with
a defibrillator
torestore a
regular beat
The patient^4
takes immune
suppressants to
preventthe body
fromrejecting
the donor heart
5
1967
The first
successful
heart
transplant
1968 Hospitals
rush to perform
more transplants
but scale back
because of high
mortality
2016 Half of heart-
transplant recipients
are expected to live
at least 13 years
1984 The U.S.
government starts
the national organ-
sharing system
1973
Pathologists
refine their ability
to detect organ
rejection
1983 Cyclosporine, a drug
that prevents organ rejection,
is approved by the FDA
2014 Non-
beating hearts
are revived on
machines, then
transplanted