By Babatunde Jose
Organ transplantation is certainly one of the “miracles” of modern medicine and one of the most challenging scientific steps of the modern era. The ability to replace, functionally or anatomically, the failing heart has been a revolutionary medical feat and in December 2020 the world marked the 53rd anniversary of the world’s first human heart transplant: And on Sunday 28 March, 2021 our brother Ahmad Olayinka Jose had a successful heart transplant; becoming one of the less than 3500 would be recipients in the year.
Throughout most of history, the heart has been regarded as the seat of human emotion and, consequently, considered to be sacred. Now, human anatomy is much better understood and even though we know that the heart is not the center of emotions, it is however affected by them, alongside stress and many other factors. Nevertheless, the heart is an organ like any other and when some organs, including the heart, fail beyond medical treatment, there is an option to surgically replace them with healthy organs from donors. Hence, transplantation.
Many brilliant and ingenious doctors and surgeons have added their names to the annals of heart transplant history. Doctors such as Dwight Harken (an innovator in heart surgery who introduced the concept of the intensive care unit), Norman Shumway (a pioneer of heart surgery at Stanford University and the first to perform an adult human to human heart transplantation in the United States, 1968), and Christiaan Barnard (a South African cardiac surgeon who performed the world’s first human-to-human heart transplant operation) all dedicated their lives to understanding this incredible organ. Their contribution to the knowledge and practice of heart surgery has changed the outcome for many people with end-stage heart failure. American medical researcher Simon Flexner was one of the first people to mention the possibility of heart transplantation. In 1907, he wrote the paper “Tendencies in Pathology,” in which he said that it would be possible one day by surgery to replace diseased human organs.
The history of heart surgery spans more than a hundred years and has seen many challenges and triumphs, including the treatment of various congenital heart defects, the development of the heart-lung machine, animal, and artificial heart transplantation, and finally, human heart transplantation.
On December 3, 1967, 53-year-old Louis Washkansky received the first human heart transplant at Groote Schuur Hospital in Cape Town, South Africa. The Surgeon, Christiaan Barnard, who trained at the University of Cape Town and in the United States, performed the revolutionary medical operation based on the technique initially developed by a group of American researchers in the 1950s.
The development of immunosuppressant drugs, which help prevent the body’s rejection of transplanted organs, added impetus to the ultimate success of these surgical procedures. Today, the only factor that limits the number of people whose lives are saved by cardiac transplants is the availability of healthy heart donors.
After the first South African transplants in 1967 other transplants were performed around the world however, by June 1970, only 10 survivors could be counted among 160 transplant recipients. But that has changed considerably, though supply of organs remains the most persistent problem in the field of organ transplantation.
Heart transplants are done in people of all ages, even children. A routine heart transplant surgery can be performed in less than four hours, while some complex ones may take seven, eight, nine hours—or more, especially if there is need to remove a heart pump or clean up scar tissue from previous surgeries. Regardless, the basic procedure remains the same. The patient is given general anesthesia and connected to a bypass machine that takes over the heart’s function. Surgeons make an incision in the chest, divide the breastbone, and remove the diseased heart. They sew the donor heart into place and connect it to the remnants of the old heart and the major blood vessels.
But given today’s shortage of available organs, the sickest patients are prioritized for transplants, so, many patients waiting for a heart to become available are already in the hospital on various types of medicine or heart pumps.
United Network for Organ Sharing (UNOS), a private, non-profit organization under contract with the government to manage the organ transplant system in the U.S., allocates newly available hearts based on such priorities as medical urgency. Patients who are hospitalized or dependent on mechanical assist devices to help their heart function are at the top of the list.
About 3,500 people in the U.S. are waiting for a heart, and many will wait more than six months. But some will die before a heart becomes available to them.
Heart transplants would not be possible if it were not for the drugs that prevent people’s bodies from rejecting the transplanted organ. These drugs have vastly improved in the last 15 to 20 years. The drugs can however have adverse effects, including high blood pressure, as well as blood sugar and kidney problems: So, there is a trade-off. One notable advance is that doctors can now tailor an immunosuppression strategy for each patient.
One reason patient can now live longer after transplantation is close monitoring and follow-up, especially in the months after their surgery. This is most intense in the first six months after a transplant, when doctors see patients frequently.
Since the performance of the first human heart transplant in 1967, heart transplantation has changed from an experimental operation to an established treatment for advanced heart disease. Worldwide, about 3,500 heart transplants are performed annually. The vast majority of these are performed in the United States (2,000–2,300 annually).
Now the testimony: We give all thanks to Almighty God for putting a smile on our face today as we make a declaration of the successful heart transplant on our brother Ahmad Olayinka Jose. He was wheeled to the theatre on Sunday 28th March shortly after a matching heart was found. The operation started immediately after he had been fully prepared and placed under anesthesia and intubated. The operation which lasted four hours ended in the early hours of Monday 29th and he was transferred to the ICU. He was gradually extubated from Wednesday 31stand on Thursday April 1st he was fully extubated and started breathing on his own; Allah be praised! On Good Friday, April 2nd, he regained full speech and was able to make phone calls to his loved ones. He also started walking unaided. And behold last Tuesday, April 6, 2021, accompanied by a retinue of medical staff, Yinka went home; a new man albeit with a lot of dos and don’ts and immunosuppressant drugs which he would use for the rest of his life. May Allah make that life a long one. Yinka has lived with a problematic heart for 25 years and ten years ago, after he was given a pacemaker, the doctor warned that he might eventually need a transplant. This is Yinka’s story, a story for another day.
We thank the surgical team and support staff of Atrium Health Carolinas Medical Center, Charlotte, North Carolina, USA for a wonderful job. Most importantly, we thank Almighty God for His mercy. TO GOD BE THE GLORY!
“Our Lord! Give us good in this world and good in the Hereafter and defend us from the torment of the Fire!”(Quran 2:201)
As we start Ramadan 2021 next week, may Allah make it easy for us and accept our fast as acts of worship.
Barka Juma’at and happy weekend
