Forty years of heart transplant

Forty years ago, the UK's first successful heart transplant was carried out at Papworth Hospital in Cambridgeshire. BHF-funded research helped to pave the way for this – but the story isn’t over. Read how we’re still helping to save lives. 


The first heart-lung machine

The first heart-lung machine was used for heart surgery. Also called cardiopulmonary bypass, this is a machine that takes on the work of the heart and lungs, so that the heart can be operated on. This is one of the developments that made open heart and heart transplant surgery possible.


First human organ transplant

The kidney was the first major organ to be transplanted successfully, in Boston, USA. The transplant was between two identical twins, so immune suppression wasn't needed. Following this, there was steady progress which helped to pave the way for transplantation of other organs. This included tissue typing, methods of preserving the organ outside of the body, and ways of allowing donor organs to be transported and shared.


Laying the groundwork

Donald Longmore starts paving the way for heart transplant surgery in the UK, despite initial scepticism. After his first application for a British Heart Foundation grant was met with "roars of laughter" he went on to receive a BHF grant of £6,000 "which in those days was a very large sum of money", enabling him to practise transplant techniques on animals.


First human heart transplant

The first human heart transplant was carried out on December 3 by a South African surgeon called Christiaan Barnard in Cape Town. The patient, Louis Washkansky (pictured), survived for 18 days. However, Dr Barnard's second patient a month later, Philip Blaaiberg, lived for nearly two years


First heart transplant in the UK

The first heart transplant in the UK was carried out at the National Heart Hospital in London on 3 May 1968. It was the world's tenth heart transplant. Surgeon Donald Ross was funded by the BHF for 20 years from 1962 onwards. He also pioneered improvements in heart valve surgery, supported by the BHF. But this first UK patient, Fred West, only survived for 45 days and the patients who received transplants soon afterwards didn't do any better.


Heart surgeons mocked

Heart transplant surgeons Donald Longmore, Donald Ross, and Keith Ross were lampooned on the cover of Private Eye after a press conference in which they waved Union Jack flags.


Heart transplantation comes to a halt

The number of heart transplants declined sharply due to difficulties in keeping the recipient alive long term – from 99 across the world in 1968 to 47 in 1969, 17 in 1970 and 9 in 1971. In 1973 the then Chief Medical Officer met with Donald Ross and other leading surgeons and doctors in the field, and they agreed to halt human transplants until more research had been done.


First successful UK heart transplant

Following more research, Sir Terence English went on to perform the UK's first successful UK heart transplant at Papworth Hospital in Cambridgeshire. The patient, Keith Castle, received his transplant on August 18 and lived for more than five years afterwards. Sir Terence also performed two more successful heart transplants at Papworth in 1979. Sir Terence had been inspired by the early transplant pioneers - he changed his career direction from cardiology to heart surgery when he worked as a junior doctor with a team that included Donald Ross. The British Heart Foundation went on to fund a research unit at Papworth that helped to make advances in heart transplant medicine.


BHF funds transplant research

The British Heart Foundation established the BHF Heart Transplant Research Group at Papworth with a grant of £300,000  with Terence English as Honorary Director. He says: “This provided core funding and enabled the appointments of a Senior Research Fellow, a Research Fellow and a Secretary to the Research Group. At the same time, the government funded extensive research into the costs and benefits of heart transplantation at Papworth and Harefield. The results of this were sufficiently impressive for the two Hospitals to receive secure funding for the development of their transplant programmes under the Supra Regional Services scheme.”


Troubled times

Transplant at Papworth received damaging publicity when Consultant Cardiologist Michael Petch withdrew his support. However, Terence English carried on with valuable support from Professor John Goodwin. Professor Goodwin had a long association with BHF and also pioneered our understanding of hypertrophic cardiomyopathy. 


Big improvements

With the help of new technologies, BHF Professor Sir Magdi Yacoub and fellow surgeon Sir Terence English dramatically improved the success rate of the heart transplant in the 1980s. When we asked Sir Magdi Yacoub why he carries out his research, he said: “I have an innate desire to know new things, to perfect what we are doing, to evaluate new forms of treatment and to study and improve surgical techniques”. 


Tackling rejection

Ciclosporin, an immune suppressant derived from a fungus found in soil, is used for the first time in a heart transplant in the UK. (Its use in heart transplant had been pioneered by Dr John Wallwork in the US in 1980.) It made a huge difference to the problem of acute rejection but came with serious side effects. 


Longest lived transplant recipient

John McCafferty (pictured) receives a heart transplant at Harefield Hospital in London, after being diagnosed with dilated cardiomyopathy at the age of 39. He was the UK's longest surviving heart transplant patient at the time of his death in 2016, age 73.


First successful child heart transplant

The first successful paediatric heart transplant took place at Columbia Hospital in New York. The recipient was James Lovette, aged four. He went on to have a second transplant at the age of 10, and he survived until 2006.


Government funding for transplant programme

Health Minister Ken Clarke announced government funding of £218,000 each to Papworth and Harefield Hospital to secure their heart transplant programme for the 1984-5 financial year.  This followed earlier scepticism. At a Wellcome Trust symposium in 1999, Donald Longmore quoted a letter from official archives, written by Ken Clarke to a fellow minister in the early 1980s, which read: “This ‘mad’ surgeon at Harefield [Magdi Yacoub] is clearly trying to do transplants. How can we stop him? Perhaps the best way would be to close Harefield Hospital and move it to Northwick Park but don’t forget, for God’s sake, not to let him know what we are up to.”  


Baby Fae's heart

Stephanie Fae Beauclair, or “Baby Fae” was the first infant to receive a non-human heart transplant. She was born in September 1984 with a congenital heart defect called hypoplastic left heart syndrome, and Dr Leonard Bailey of California’s Loma Linda University Medical Center transplanted a tiny baboon heart into her chest. She survived for 20 days before dying from acute rejection. The case did serve to highlight the shortage of baby hearts for transplant, a shortage which still remains today. 


First successful paediatric heart transplant in UK

Kaylee Ann Davidson-Olley was just four months old when she had a transplant at the Freeman Hospital in Newcastle. Kaylee, now 32, says: “I had viral dilated cardiomyopathy and my only chance of survival was a heart transplant. At the time there were no known babies in the UK where this had been successful.” Kaylee has since competed in the Transplant Games several times, but had a setback in 2014 when she became seriously ill. She says: “I have been unable to work since then, and had to stop athletics. But now I am on the way up again, and am going back to the gym." In October 2017 Kaylee celebrated 30 years since her transplant with other transplant patients, by walking over Newcastle’s Millennium Bridge promoting organ donation.


A new heart after cancer treatment

First successful paediatric heart transplant in the UK at the Freeman Hospital in Newcastle. Kyle Garlett fought cancer four times, starting when he was just 18. Repeated chemotherapy left him with a severely damaged heart. Since his heart transplant Kyle, now 47, has taken part in two extreme Ironman triathlons and competed in two Transplant Games.


First beating heart transplant

UK’s first beating heart transplant, using the organ care system, at Papworth Hospital. Before this, organs for transplantation had to be kept at 4 degrees but the new system meant that they could be kept warm and supplied with blood, to improve the chances of successful transplant.


Kieran's story

Kieran Sandwell, who was born with a congenital heart condition called transposition of the great arteries, receives a heart transplant. He went on to walk around the entire coastline of the UK in 2017, in aid of the BHF. You can sponsor him on Just Giving or text TOTH99 and your amount to 70070. 


Wendy's story

Wendy, from York, received a heart transplant aged 32, having developed peripartum cardiomyopathy after giving birth to her son Joshua at the age of 23. When her condition worsened, Wendy was told she had six to 12 weeks to live without a transplant. Her recovery was difficult and she spent three months in hospital, but Wendy has completed the BHF’s Heart of York bike ride several times, as well as the British Transplant Games.


Heart in a box

World’s first adult non-beating heart (also called DCD or Donation after Circulatory Death) transplant in Sydney using a ‘heart in a box’ or machine perfusion.


Europe’s first non-beating heart transplant

Europe's first non-beating heart (DCD) transplant at Papworth Hospital. Previously, donor organs were only taken from donors who had suffered brain stem death, who were dependent on a ventilator but who still had beating hearts. Using non-beating hearts after cardiac death has the potential to increase the number of hearts available for transplant.  There were 14 DCD heart transplants in the UK in 2016-2017.


Jim’s electric heart

Jim Lynskey becomes one of the youngest people in the UK to receive a LVAD, a mechanical heart pump that keeps him alive while he waits for a heart transplant. He had developed dilated cardiomyopathy after catching viral meningitis as a baby. Read Jim’s story of living with an artificial heart.


Top professor tackles transplant rejection

Professor Federica Marelli-Berg is appointed BHF Professor of Cardiovascular Immunology at Queen Mary University of London – an appointment that puts her in a select group of the most talented heart researchers in the UK. She is looking to ‘hijack’ the immune system to stop it attacking the transplanted heart. 


We are funding millions of pounds worth of heart transplant research projects around the UK, to reduce the risk of rejection and improve long-term outcomes. One project, at King’s College London, is looking at how to give children who have heart transplants the best chance of survival. We’re also funding many other projects to help the heart to repair itself, so that fewer people ever need a heart transplant.