science

Transplant surgery has come a long way

Kettlemag, Lindsay Dodgson, heart, anatomy, heart drawing
Written by Linzasaur

Transplant surgery of some sort has been around since 1908. A French surgeon named Alexis Carrel thought up the method of transplanting organs between animals. Unfortunately, many of his experiments failed because the donor organs were rejected.

The first successful transplanted organ was a kidney, which happened between identical twins in 1953. The 1950s also saw the creation of anti-rejection drugs which lead to the first ever heart transplant in 1967 by Christiaan Barnard in South Africa.

Before World War II, surgeons were considered mad if they attempted to operate on the human heart. It was considered too delicate and unfamiliar to tamper with. They bled too much and they acted like no other organ in the body, so they were best left alone as the patient would most likely die anyway.

World War II Hospital field with soldiers

Image : [Flickr / Otis Historical Archives National Museum of Health and Medicine]

Soldiers, some still teenagers, coming home with horrendous injuries forced doctors out of their comfort zone, and so heart surgery advanced tremendously in WWII. Innovative surgeons tried daring new procedures out of necessity for the first time, which was the very beginning of what we consider heart surgery today.

Advances in speed, safety and effectiveness

It’s not just heart operations that has come leaps and bounds either, as transplant surgery is now generally more quick, successful and common than it has ever been. The clock is ticking for surgeons once the organ is removed from the body, but progressions in medicine mean that ways to make the procedures more effective and safe are being made. 

Last month, surgeons successfully transplanted a heart that had stopped beating into a patient, and the patient lived. Until this procedure, doctors relied on using the still beating hearts of donors that were declared brain dead. These hearts have to be rushed to the patient on ice to keep them alive. 

At Sydney’s St Vincent’s Hospital and the Victor Chang Cardiac Research Institute, a technique has been developed which means the donor heart can be resuscitated after being still for 20 minutes. They manage this by transferring the heart to a portable machine, which is called a “heart in a box” where it can be kept warm in a preservation solution. This means that people that have been declared heart dead, not just brain dead, might also qualify as heart donors.

Being able to re-animate a dead heart is particularly significant in countries where the definition of death can differ. Executive director of the Vincent Chang Institute Bob Graham said in a press release “This will potentially open up heart transplantation in countries like Japan, Vietnam and other places where the definition of death is heart death, not brain death.”

Paralysed man walks again

October also brought a medical revelation. A paralysed man walked again after a pioneering surgery which involved transplanting stem cells from his nose into his damaged spinal cord. These particular cells are special because they have the ability to turn into any other type of cell in the body. Polish surgeons, lead by leading exper Dr Pawel Tabakow, placed the cells where the cord was damaged to provide a pathway for new tissue to grow and the patient is now believed to be the first person ever to recover from complete severing of the spinal cord.

Transplant surgery was considered science fiction just 70 years ago but by 2010, surgeons had managed to transplant almost anything, including an entire face. One major organ that has yet to be attempted, however, is the eye. Blindness is common all over the world for a variety of different reasons and remains a tricky problem to tackle.

Despite this, surgeons remain hopeful that no organ, including the eye, is impossible to transplant. “It’s a scientific long shot,” said Dr Jeffrey Goldberg, director of research at the Shiley Eye Center at University of California, in an article on WebMD. “But it’s a very attractive long shot.”

Image: [Flickr / University of Liverpool Faculty of Health & Life Sciences]