test 8 history of transplants

Question 1

1905 – Carrel and Guthrie

Answer 1

 Described first heterotopic transplant of a donor heart into the neck of a dog
 Not a functional model, functioned together with the recipient’s heart
 Heart was not capable of supporting circulation
 Lasted 2 hours before the chambers clotted

Question 2

Carrel and Guthrie – University of Chicago

Answer 2

 Created innovative surgical technique for vascular anastomoses.
 Carrel won the Nobel Prize in Medicine and Physiology in 1912 for his work in this area.

Question 3

1933 – Mann, et al. at Mayo Clinic

Answer 3

 Heterotopic transplant with circulatory unloading of the RV
 Working model
 Lasted 4 days
 Observed – failure of the transplanted heart was not always caused by faulty surgical technique, but to “some biologic factor which is probably identical to that which prevents survival of other homotransplanted tissues and organs”
 Described acute allograft rejection

Question 4

1960 – Lower and Shumway

Answer 4

 Orthotopic heart transplant in dogs with CPB and topical hypothermia for donor heart preservation
 Survived 6-21 days
 Died of rejection

Question 5

1960s

Answer 5

– Pharmacologic immunosuppression introduced.
 Not long after – First clinical transplantation occurred
 Kidney

Question 6

1967 and into the 1970s

Answer 6

 First human heart transplant was performed in South Africa
 Followed shortly by Shumway and colleagues at Stanford in 1968. (first OHT in the US)
 Lots of centers rushed to perform transplants
 Realized post operative survival was limited
 Lots of opportunistic infections
 Graft rejections
 Most centers discontinued doing transplants in the 1970s

Question 7

1980s

Answer 7

– cyclosporine-based immunosuppression introduced

 Interest in transplantation re-emerged.