Der Beitrag Christian Barnards zur Geschichte der Transplantationsmedizin

Zusammenfassung

Christian Barnard führte am 3. Dezember 1967 die erste orthotope Herztransplantation am Groote Schuur in Kapstadt, Südafrika durch. Barnard konkurrierte dabei mit den amerikanischen Herzchirurgen Adam Kantrowitz, Norman Shumway und Richard Lower, welche die experimentellen Grundlagen für den Eingriff legten. Der Empfänger, Loius Washkansky, überlebte 18 Tage. Barnards Leistung ist als Pioniertat in die Medizingeschichte eingegangen und wurde unterstützt durch die gute interdisziplinäre Zusammenarbeit am Groote Schuur, die finanzielle Stabilität und dem hohen wissenschaftlichen Stand der südafrikanischen Medizin in den 60igern. Kontrovers diskutiert werden die anfänglich unselektive Patientenauswahl, die fehlenden gesetzlichen Bestimmungen zur Organentnahme in Südafrika und die unzureichenden therapeutischen Möglichkeiten der Verhinderung der Transplantatabstossung. Auch noch 2011 unterhält die Klinik ein Transplantationsprogramm und betreibt international renommierte Forschung auf dem Gebiet der Biomechanik und invivo tissue engineering.

Abstract

On December 3 rd, 1967, Christian Barnard conducted the first orthotopic heart transplant at Groote Schuur hospital in Cape Town, South Africa. Barnard competed with the American heart surgeons Norman Shumway, Adam Kantrowitz and Richard Lower, who laid the experimental foundations for the operation in the previous years. The patient, Loius Washkansky, survived 18 days. Today, Barnard is revered as a pioneer in the history of medicine. However, his achievement is discussed controversially due to the unselective choice of patients, the lack of legal provision for the removal of organs in South Africa, and the absence of therapeutic options for prevention of transplant rejection. Barnard's success was supported by a well established interdisciplinary cooperation within different departments at Groote Schuur. The financial stability and the high standard of science in South Africa in the 1960 s contributed to this surgical victory. In 2011, the Department maintains a transplant program and conducts international renowned research in the field of biomechanics and in vivo tissue engineering.

• Literatur

• 1 Anonymous. A definition of irreversible comaReport of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death. JAMA 1968; 205: 337-340
• 2 Banner NR, Yacoub MH. Cyclosporine in thoracic organ transplantation. Transplant Proc 2004; 36: 302S-308S
• 3 Barnard CN. The operation. A human cardiac transplant: an interim report of a successful operation performed at Groote Schuur Hospital, Cape Town. S Afr Med J 1967; 41: 1271-1274
• 4 Benatar SR. Health care reform and the crisis of HIV and AIDS in South Africa. N Engl J Med 2004; 351: 81-92
• 5 Bezuidenhout DDN, Black M, Schmidt C et al. Covalent surface heparinization potentiates porous polyurethane scaffold vascularization. J Biomater Appl 2010; 401-418
• 6 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 – with reference to the operation. A human cardiac transplant: an interim report of a successful operation performed at Groote Schuur Hospital, Cape Town. Cardiovasc J Afr 2009; 20: 31-35
• 7 Hassoulas J, Barnard CN. Heterotopic cardiac transplantation. A 7-year experience at Groote Schuur Hospital, Cape Town. S Afr Med J 1984; 65: 675-682
• 8 Levey RH, Medawar PB. Nature and mode of action of antilymphocytic antiserum. Proc Natl Acad Sci U S A 1966; 56: 30-37
• 9 Lower RR, Stofer RC, Hurley EJ et al. Successful homotransplantation of the canine heart after anoxic preservation for seven hours. Am J Surg 1962; 104: 302-306
• 10 Sade RM. Transplantation at 100 years: Alexis Carrel, pioneer surgeon. Ann Thorac Surg 2005; 80: 2415-2418