| The Nasty Side of Organ Transplanting Second Edition Norm Barber Copyright Chapter 18 A Short History of Human and Xeno Transplanting Human Transplant History From about 1700 human skin had been transplanted in India to burns, disease and injury victims. 1905 Frenchman Alexis Carrel began the modern age of organ transplanting when he developed a method of joining blood vessels. 1905 Human blood began to be transplanted with less than happy results because blood types weren’t distinguished. 1933 Serge Veronoff, a Russian living in France, performed the first recorded kidney transplant without the benefit of tissue typing. It failed.69 1954 First Successful Kidney Transplant 1958 Dr Raben of the USA produced hGh (Human Growth Hormone) using harvested Pituitary glands from morgue corpses to promote growth in dwarfs and increase fertility in women who couldn’t get pregnant. The Australian program began in 1965 and finished in 1985 both here and in most of the world due to the spread of Creutzfeldt-Jakob disease from infected glands. 1966 First simultaneous pancreas/kidney transplant in United States. 1967 First successful liver transplant by Tom Starzl in Denver, Colorado. 1967 Christiaan Barnard, in South Africa, transplants first human heart. Barnard was a son of a Christian missionary, screwed three separate women in one night, had two women at one time and also did it to Gina Lollabrigida. His second wife was 27 years younger than himself and his third wife 39 years younger and whom he met when she was six. Barnard’s work suffered due to international sanctions against South Africa, his arthritis and refusal to leave his country. He was, perhaps, a great man.70 1968 First Heart transplant in USA 1972 Jean Borel discovers cyclosporin, the anti-rejection drug made from a poisonous Norwegian fungus. It was approved for use in 1983 and is still the most popular immune suppressant drug used in transplantation today. 1981 First successful heart-lung transplant in USA 1983 First single lung transplant (Canada) 1986 First successful double lung transplant (Canada) 1988 First combined liver and intestine transplant 1989 First successful liver transplant using a living donor. A portion of a living person’s liver was cut off and transplanted to a relative. 1990 First successful transplant where a portion of a living person’s lung was cut out and put into a relative. 2000 First successful lung transplants using organs harvested from cardiac dead (completely dead) donors. Performed in Sweden. Previously lungs were only removed from fully living or “brain dead” donors with beating hearts. Xeno History 1628 Sheep blood transfused to humans in Padua, Italy. 1682 Bones from dog’s skull transplanted into head of wounded soldier. Late 1800’s in England. Sheep blood injected into wayward husbands and troublemakers to make them calm or at least sick. Skin cut from living frogs and put on human burns and ulcers. Size of graft was determined by the wriggling of the frogs trying to escape. 1906 Princteau’s failed attempts to transplant rabbit kidney sections into humans. 1910 Ernst Unger puts monkey kidneys into a human. They failed, as did his transplanting a kidney from a stillborn baby into a Baboon.71 1913 Serge Voronoff transplants thyroid of chimp into boy aged 14. Failed. 1914 Sheep’s blood transfused to wounded soldiers. 1914 Bone transplant from animal to wounded soldier in France by Russian surgeon Serge Voronoff. 72 1920-1923 Serge Voronoff does a series of testicle transplants from monkeys and chimpanzees to elderly men who reported renewed vigour.73 1923 Neuhof transplanted a sheep kidney into a human patient who died nine days later. 1958 First successful heart transplant, from one dog to another, by Norman Shumway in the United States. Norm was incredibly pissed off when Christiaan Barnard beat him to the human heart transplant, but regained his composure and became one of the leading surgeons in the world. 1963 Keith Reemtsma of U.S.A. transplanted a chimpanzee kidney into a human patient who lasted 63 days. Another one lived nine months with the kidney operating for six. 1964 Dr James Hardy of Mississippi did the first heart transplant from a chimpanzee into a human. The hospital allowed the consenting relatives to believe the new heart would be from a human. You can imagine their surprise when they discovered their child got a chimp’s heart. The patient died during surgery. 74 1965 Tom Starzl, sometimes known as FrankenStarzl, did six baboon-to-human kidney transplants. All kidneys survived hyperacute rejection but were destroyed within two months from human immune system attacks. One wild set of kidneys produced fifty litres of urine in 24 hours, which killed the patient.75 1966 to 1973 Tom Starzl transplanted three livers from chimpanzees to children. All died within fourteen days. 1968 Denton Cooley in Houston, Texas transplanted a sheep’s heart into a human patient. Donald Ross in London, England transplanted a pig’s heart into another human. Both hearts were attacked within minutes by the patient’s immune systems and they died. 1977 Christiaan Barnard transplants two chimpanzee and baboon hearts to humans as auxiliaries until their own hearts could recover. The chimpanzee heart was rejected after four days. The baboon heart wasn’t big enough to support circulation. Both patients died as their own hearts hadn’t recovered. 1984 Dr Leonard L. Bailey, of Loma Linda Seventh-day Adventist Hospital in California, put a Baboon heart into a baby girl called Fae. The kid lasted twenty days. He said it gave him good practice. The hospital got 75 complaints about cruelty to Fae and 13,000 for the Baboon. Leonard Bailey was advised to wear a bulletproof vest. It was ironical that a church specialising in vegetarianism would be a leader in body parts transplanting particularly from animals to humans. 1992 Pig heart to human performed in Sosnowiec, Poland. It failed and the patient died. 1993 Leonard Makowka puts a pig liver into a human. It fails. 1992 and 1993 Tom Starzl did two baboon to human liver transplants. Both patients died. One lived seventy days. Protesters picketed his house calling him Tom FrankenStarzl. The name stuck. 1996 India Pig heart to human. Patient died and the surgeon jailed. When he got out he said he was going to do more.76 Experiments on Animals After Tom Starlz’ failed xeno transplants public and professional attitudes hardened saying that humans shouldn’t be used for virtual experiments until further progress was made on reducing immune reaction to animal organs. The focus then went on performing transplants between different species of animals and conditions, predicably, got rather nasty for the animals. Duke University in the USA collaborated with Nextran Incorporated while Cambridge University of the UK joined with Novartis. They performed a series of experiments transplanting pig kidneys to baboons attempting to stop the hyperacute rejection of organs between species. The animals that received the transplanted organs survived from thirty minutes to 35 days. Duke University/Nextran also did heterotopic heart transplants from pigs to baboons where the baboon hearts were left pumping but a functioning pig heart was also attached. Survival was from 6 hours to 5 days. The research scientists also did pig to baboon lung transplants with the baboons lasting as little as ten minutes to five hours. The sickening descriptions of these experiments are not worth printing but suffice to say that this is the high moral price we pay for developing transplant expertise. Using animals for human transplanting has been with us since the 1700’s, in England, when the bloodstream of a living sheep was attached to a patient with liver failure and in a coma. The sheep’s liver cleansed the man’s blood and he awoke full of vigour, but in what at best could be described as a strong display of ingratitude, he jumped out of bed and killed the sheep. Christiaan Barnard used the same technique in South Africa when he wheeled a baboon into a hospital ward and attached its blood stream to a liver failure patient, who had fallen into a coma, and was at risk of brain damage from blood toxins. Barnard, perhaps hearing of the sheep story, covered the baboon so as not to distress others and sedated both the baboon and patient to avoid any unpleasant reactions. The animal’s liver cleansed the human’s blood and the man recovered. The baboon suffered little detriment except for temporary jaundice and a bad temper. As stated elsewhere in this book, harvested pig and baboon livers are attached to human blood streams and used for temporary liver cleansing when a patient suffers short-term acute liver failure. The patient’s own liver may recover or at least survive until a transplant liver is available. Judith Brumm, a theatre nurse and clinical program coordinator at Baylor University Medical Centre in Texas, reports a pig liver used to keep alive a liver-failure patient. The pig was specially raised in a sterile environment. Its liver was surgically removed and placed in a dish next to the patient whose blood was perfused for seven hours over three days. It kept the patient alive until a transplant became available76a Japanese Transplants Transplantation’s lack of popularity in Japan isn’t purely because of the Shinto and Buddhist religions. Juro Wado did his bit as well. Dr Wada, Japan’s first heart transplant surgeon, found an eighteen year old drowning victim with a harvestable heart. His first mistake was declaring the boy dead instead of letting an independent doctor make the determination. His second mistake was putting the boy’s heart into a patient who apparently didn’t need a transplant and, in any case, died twelve weeks later from organ rejection. An investigation indicated the patient only needed a valve replacement, a much safer procedure. Dr Wada’s reputation suffered further when the investigators discovered the deceased patient’s original heart had disappeared and when found the valves had been removed and put in a separate place. When they were examined one had a different blood type suggesting the deceased patient’s original valves had been removed to confuse the investigators. Dr Wada blamed the misplacement of the valves on a younger surgeon who had recently died of gastric cancer and, conveniently for Dr Wada, couldn’t testify. The Japanese prosecution charged Dr Wada with double murder saying the donor hadn’t been proved dead and that the deceased recipient had only needed a simple mitral valve replacement. The charge was eventually dropped. This was followed by a series of similar incidents leaving the Japanese public with major suspicions of transplant medicine. |