The man with a young woman's heart

Fifty years ago South Africa stunned the world: A surgeon in Cape Town, Christiaan Barnard, successfully transplanted the heart of a woman into the chest of a dying man.

Here is a narrative, largely based on AFP reporting at the time, of the extraordinary details surrounding the first human-to-human heart transplant.

A terrible accident

Ann Washkansky could not have imagined that the traffic accident she comes across on December 2, 1967, would bring both life and fame to her terminally ill husband.

As Washkansky is driving back from visiting her husband at Groote Schuur Hospital in Cape Town when she sees a vehicle slam into Denise Darvall, a young bank worker, as she is crossing a busy road.

Her body flies through the air and her head smashes into a parked car, fracturing her skull. It is soon clear that Darvall is brain dead. But her heart is still beating.

'Save this man'

Louis Washkansky, 53, has been told he has only weeks left to live because of severe heart failure.

He accepts without hesitation a barely imaginable proposition from Barnard: a heart transplant.

Successful transplants of kidneys and livers have been carried out for years but none so far with a human heart, the core of life itself.

The father of 25-year-old Denise quickly gives his consent.

"If you can't save my daughter, you must try and save this man," Edward Darvall is quoted as saying in Donald McRae's 2006 book "Every Second Counts: The Race to Transplant the First Human Heart".

'It's going to work!'

The operation starts in the early hours of December 3.

Denise's heart is removed and placed in a 10-degree Celsius (50-degree Fahrenheit) solution for transfer to an operating room where around 20 doctors, nurses and technicians are gathered around Louis.

The tension is knife-edge, a young intern who was present recounts in an AFP story filed the following day.

"When the last anastomosis (connection) was done, it was the moment of truth. Everyone craned their necks for a better view. In the complete silence, Professor Barnard murmured: "it's going to work!'," says the intern, whose name is not given.

"The anaesthetist then called out the pulse rate: 50, 70, 75 and then, half an hour later, 100," the intern recounts.

"The mood was extraordinary. We knew everything had gone well. Suddenly, the professor removed his gloves and asked for a cup of tea."

'A new heart'

"I am much better," Washkansky is quoted as saying in his first conversation, about 33 hours after the operation, with the surgeon he calls "the man with the golden hands".

"I gave you a new heart," Barnard says.

The news spreads. At 1:17 pm on December 3, AFP's telex machines rattle out a short piece, originally in French: "A heart transplant, believed to be the first in the world, was successfully carried out today at Groote Schuur Hospital in Cape Town."

It was a complete surprise as "everyone" expected that such a first would come from the United States, an AFP medical correspondent writes.

'World renowned' overnight

With a beaming smile, good looks and a way with words, Barnard, the 45-year-old South African surgeon, quickly becomes a media star.

"On Saturday," he says in an interview 30 years later, "I was a surgeon in South Africa, very little known. On Monday, I was world renowned."

Four days after the groundbreaking procedure, Louis Washkansky gives a short radio interview from his hospital bed. The microphone has been sterilised and the reporter has to stay at the door of the room to avoid infecting the patient.

He becomes known as "the man with the heart of a young girl", and his vitality and good humour are astonishing.

To a visiting French doctor, he says: "Tell the Parisians to make a collection and buy me a plane ticket and I will come over and see them."

But he would not have the opportunity to travel. Washkansky dies from pneumonia 18 days after the transplant, his heart still functioning but his immune system weakened by the drugs used to prevent his body's rejection of the new heart.

Barnard, meanwhile, embarks on a world tour as the latest pioneer of modern medicine.

The world's first organ transplants

Fifty years after the first heart transplant in South Africa, here is look back over the history of human organ transplants.

The discovery of the immunosuppressive effects of cyclosporine, derived from a microscopic fungus, gave new impetus to transplants from the early 1980s, greatly reducing the risks of organ rejection.

Skin

In November 1869 Swiss doctor Jacques-Louis Reverdin carries out in Paris the first modern skin transplant. He covers a wound on a patient's left elbow with skin taken from their right arm.

Kidney

In June 1950 in the US city of Chicago, doctor Richard Lawler transplants the kidney of a deceased person into a woman. The organ is rejected after 10 months but the patient survives for five years.

Two years later in Paris, the team of Jean Hamburger carries out the first kidney transplant from a living donor. The patient dies 21 days later.

Liver

In 1963 in the US city of Denver, Thomas Starzl attempts the first liver transplant but the three-year-old patient dies.

The professor is more successful in 1967 when the 19-month-old organ recipient survives for more than a year.

Lung

The first lung transplant is carried out in June 1963 in Jackson, United States, by James Hardy. The patient survives 18 days.

Heart

Christiaan Barnard carries out the first human-to-human heart transplant in December 1967 in Cape Town. The patient survives 18 days but dies from pneumonia.

The first transplant with an artificial heart is carried out in December 1982 in Salk Lake City in the United States. The patient survives 122 days.

Larynx

In January 1998 in Cleveland, United States, a successful larynx transplant is carried out on a man who has lost his vocal cords in a motorcycle accident. It is only made public in 2001.

Hand

In September 1998 at Lyon, France, the team of Professor Jean-Michel Dubernard transplants a donor's hand on to a 47-year-old New Zealander. It is amputated in February 2001 after the patient abandons his anti-rejection treatment.

In January 2000 a transplant of a patient's two hands and the lower part of his forearms is carried out by Dubernard.

Tongue

The first successful tongue transplant is carried out in July 2003 in Vienna on a person suffering from mouth cancer.

Face

In November 2005 in Amiens, France, a partial face transplant involving nose, lips and chin is carried out on a woman disfigured by her dog, by the team of Dubernard and Bernard Devauchelle.

In March 2010 in Barcelona, Spain, a group led by Joan Pere Barret carries out the first successful complete face transplant on a man deformed in an accident.

In August 2015 in New York the team of Professor Eduardo Rodriguez carries out a complete face transplant including the scalp, ears and ear ducts. It is considered the most comprehensive face transplant to date.

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