How the world’s first heart transplant almost didn’t happen due to medical ‘rivalries and immense hostility’


How the world's first heart transplant almost didn't happen due to medical 'rivalries and immense hostility'

The first attempt at a heart transplantation in Britain had actually taken place 11 years earlier, but the patient had lived for only 45 days.

Similarly poor outcomes in a number of patients over the following year persuaded health chiefs to ban the practice.

But by 1979 the powerful immunosuppressant drug ciclosporin had been discovered, which helped prevent the immune system rejecting donor organs.

During that time Sir Terence had been training with top US transplant surgeons, meanwhile building up a team of specialists at Papworth, waiting for the mood to change.

He was refused funding by the Department of Health, and told he must under no circumstances perform a heart transplant, but the NHS manager for Cambridgeshire believed in the programme and gave the money for two procedures.

However, this did not impress (now) Sir Roy Calne, a kidney transplant pioneer to whom Sir Terence had previously promised they would initiate a heart transplant programme together at Calne’s Addenbrooke’s hospital base.

Sir Terence says the resulting disagreement was so profound that Sir Roy instructed units under his control – where most of the donors arrived – not to send donor hearts to Papworth.

“A lot of the units that were sending [donor] kidneys were told he wasn’t going to accept any if they were also sending hearts.

“It was difficult – I could have handled things better, I think.”

Sir Roy had not accounted for his senior registrar, Paul McMaster, who believed Sir Terence should have the chance to operate and offered the heart in his superior’s absence.

Subsequently the president of Medecins Sans Frontieres UK, McMaster had done exactly the same thing seven months earlier.

However, the recipient on that occasion, Charles McHugh, had suffered brain damage while waiting for the organ and died three days after the operation.

“I had to go to the Department of Health and explain what had happened,” said Sir Terence.

“But they did not know that I had one more shot, and that I was going to use it.”




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