Inside the beating heart of first transplant

At 1am on December 3, 1967 Professor Christiaan Barnard and his team of cardiac surgeons, nurses and perfusionists were making history, performing the world’s first human heart transplant at Groote Schuur Hospital.

Dene Friedmann, from Kenilworth, a student perfusionist at the time, was in the operating theatre when the heart of donor Denise Darvall was successfully transplanted into the chest of Louis Washkansky. Her role as a student perfusionists was to assist the chief perfusionists operating the heart-lung machines.

Ms Freidmann said the entire cardiac team had been on 24-hour call for about a month waiting for a suitable heart donor to become available. She was at home on Saturday evening December 2 when the call came at about 10pm, summoning her to Groote Schuur Hospital.

“I knew it must be for the heart transplant and was very excited as we were about to do something that had never been done anywhere in the world before.

“We all had great trust in Professor Barnard as our leader and as a surgeon and felt confident that the operation would be successful.”

When she got to the hospital theatre, the atmosphere was very serious and quiet.

“No one spoke unnecessarily, we were all preparing the theatres and everyone felt sad having just heard about the tragic accident that had happened 2km from Groote Schuur Hospital resulting in the death of Myrtle Darvall and her daughter, Denise.”

The operation began at 1am, the donor in one theatre and
the recipient in the adjoining theatre.

Denise Darvall had earlier been declared brain dead by two neurologists and after getting permission from her father, Edward Darvall, to donate her heart and kidney, she was transferred to the ward as a potential donor.

In 1967 there was no true legal definition of death and therefore Professor Barnard was able to use the concept of brain death for the donor. It is now universal for all cardiac donors that they must be brain dead but with a beating heart.

Because Denise Darvall was the world’s first heart donor, Professor Barnard would not allow the surgeons to start opening her chest until the respirator to which she was attached had been switched off and her heart was allowed to stop beating on its own.

“This was so that no one could say he removed a beating heart from a donor,” said Ms Friedmann.

At 6am on the Sunday morning the donor heart started to beat in the chest of Mr Washkansky.

“From the quietness in the theatre everyone started smiling and calling out congratulations to Professor Barnard. We were all very happy, especially for brave Mr Washkansky,” she says.

At 8.30am everything was completed and Mr Washkansky was moved to his isolation ward.

“I remember walking out of the hospital and it was very quiet. Later that Sunday evening this was a different story as the press from all over the world started arriving at the hospital to cover the story,” she says.

Ms Friedmann continued to be part of Professor Barnard’s cardiac team until his retirement in 1984. She then continued working at Groote Schuur Hospital running the heart-lung machine for open heart-surgery, eventually as chief perfusionist until 1995 when she left to join Christiaan Barnard Memorial hospital working as a perfusionist there until 2016.

Professor Barnard, the pioneer human heart transplant surgeon, put Groote Schuur Hospital on the map in 1967 and up until today 544 heart transplants have been performed at Groote Schuur Hospital and the operations are still taking place.

Hospital chief executive officer Dr Bhavna Patel says the first heart transplant operation was a catalyst for their 81-year-old hospital to grow into a culture of innovative thinking.

“The event placed our hospital in the spotlight internationally and together with the University of Cape Town, we wish to continue this trend in order to serve all our patients in the best way possible.”

The legacy of Professor Barnard’s work is continued at the Heart of Cape Town Museum, located in the very place where the first heart transplant took place.

Visitors to the museum can go on a tour of all the events leading up to the first heart transplant. The tour starts with Denise Darvall’s car accident and leads to the actual theatre where the heart transplant took place.

Professor Barnard and his team are represented by life-size dummies.

Another display shows Professor Barnard checking up on Mr Washkansky.

Museum tour guide Tracy Adamo says it is an amazing part of South African history.

“Apart from tourist visits, the museum is also recognised by the Western Cape Education Department as part of a school outing to teach the children about the historical moment,” she said.