Editing Christiaan Barnard (section)

==Additional heart transplants==
Barnard and his patient received worldwide publicity.<ref name="Organ Donation, GlobalViewpoints, Margaret Haerens editor, 2013">[https://books.google.com/books?id=8IRmDwAAQBAJ&dq=%22The+amount+of+publicity+generated+by+the+first+heart+transplant+was+extensive.++Critics+viewed%22&pg=PA18 Organ Donation], GlobalViewpoints, Margaret Haerens editor, Detroit, New York, San Francisco, New Haven, Conn., Waterville, Maine, U.S.; London, England, UK: Greenhaven Press, 2013.</ref><ref name="Every Second Counts, regarding international publicity of Barnard's first heart transplant, esp. pages 207 and 208">''Every Second Counts'', McRae, see [https://books.google.com/books?id=nBYTCwAAQBAJ&dq=%22On+Monday+morning%2C+as+international+news+teams+flocked+to+Cape+Town%2C+the+BBC+and+CBS+leading+the+first+requests+for+exclusive+interviews%22&pg=PA207 page 207] and, regarding publicity in the Soviet Union, [https://books.google.com/books?id=2Fv9dRT9TC4C&dq=%22In+Moscow%2C+Pravda+gave+over+its+front+page+to+the+news+and+suggested+to+its+readers+that+in+spite+of+South+Africa%27s+backward+place%22&pg=PT180 pages 208–09] in which ''Pravda'' states, "in spite of South Africa's backward place in the community of nations, positive, creative forces seem to thrive there, as proven by the immense feat of Dr. Chris Barnard."</ref> A 2017 BBC retrospective article described the occasion as one where "Journalists and film crews flooded into Cape Town's Groote Schuur Hospital, soon making Barnard and Washkansky household names." Barnard himself was described as "charismatic" and "photogenic" while initial reports labeled the operation as "successful" despite the death of Washkansky 18 days later.<ref name="The operation that took medicine into the media age, BBC, 2017">[https://www.bbc.com/news/health-42170023 The operation that took medicine into the media age], BBC, Ayesha Nathoo (Centre for Medical History, University of Exeter), 3 December 2017. The photo caption incorrectly states [[Louis Washkansky]] was the first heart transplant recipient, when in actuality he was second. [[Boyd Rush]] with physician James D. Hardy was the first person to receive a heart transplant in 1964.</ref>

Worldwide, approximately 100 transplants were performed by various doctors during 1968.<ref>[http://dspace.ucalgary.ca/bitstream/1880/48963/1/2009_HMD_Elzinga.pdf Major Medical Milestones Leading Up to the FirstHuman Heart Transplantation] {{Webarchive|url=https://web.archive.org/web/20160714140947/http://dspace.ucalgary.ca/bitstream/1880/48963/1/2009_HMD_Elzinga.pdf |date=14 July 2016 }}, Kate Elzinga, from ''Proceedings of the 18th Annual History of Medicine Days Conference 2009: The University of Calgary Faculty of Medicine, Alberta, Canada'', Cambridge Scholars Publishing, 2011. ".. following Barnard's landmark heart transplantation on December 3, 1967, 107 human heart transplants were performed by 64 surgical teams in 24 countries in 1968. . "</ref> However, only a third of these patients lived longer than three months. Many medical centers stopped performing transplants. In fact, a US [[National Institutes of Health]] publication states, "Within several years, only Shumway's team at Stanford was attempting transplants."<ref name="Adrian-Kantrowitz-Papers" />

Barnard's second transplant operation was conducted on 2 January 1968, and the patient, [[Philip Blaiberg]], survived for 19 months.<ref name=New-York-Times-2001-obituary-Christiaan-Barnard/><ref name="Chicago-Tribune-Philip-Blaiberg-1968">[http://archives.chicagotribune.com/1969/10/12/page/254/article/philip-blaiberg-was-dying-this-time-for-certain Philip Blaiberg was dying—this time for certain], ''Chicago Tribune'', Mrs. Philip Blaiberg, 12 October 1969, page 68.</ref> Blaiberg's heart was donated by Clive Haupt, a 24-year-old black man who suffered a stroke, inciting controversy (especially in the African-American press) during the time of South African apartheid.<ref>{{Cite journal |last=Koretzky |first=Maya Overby |date=2016 |title='A Change of Heart': Racial Politics, Scientific Metaphor and Coverage of 1968 Interracial Heart Transplants in the African American Press |journal=Social History of Medicine |volume=30 |issue=2 |pages=408–428 |doi=10.1093/shm/hkw052 |pmc=5914447 |pmid=29713117}}</ref> Dirk van Zyl, who received a new heart in 1971, was the longest-lived recipient, surviving over 23 years.<ref>{{Cite news |date=7 July 1994 |title=Dirk van Zyl, 68; Had '71 Transplant |url=https://www.nytimes.com/1994/07/07/obituaries/dirk-van-zyl-68-had-71-transplant.html |access-date=28 March 2009 |work=The New York Times}}</ref>

Between December 1967 and November 1974 at Groote Schuur Hospital in Cape Town, South Africa, ten heart transplants were performed, as well as a heart and lung transplant in 1971. Of these ten patients, four lived longer than 18 months, with two of these four becoming long-term survivors. One patient, [[Dorothy Fischer]], lived for over thirteen years and another for over twenty-four years.<ref name="South-African-Medical-Journal-2012">[http://www.samj.org.za/index.php/samj/article/view/5020/4123 Transplantation of the heart: An overview of 40 years' clinical and research experience at Groote Schuur Hospital and the University of Cape Town], ''South African Medical Journal'', "Part I. Surgical experience and clinical studies." J Hassoulas, Vol. 102, No. 6 (2012).</ref>

Full recovery of donor heart function often takes place over hours or days, during which time considerable damage can occur. Other deaths to patients can occur from preexisting conditions. For example, in pulmonary hypertension the patient's right ventricle has often adapted to the higher pressure over time and, although diseased and hypertrophied, is often capable of maintaining circulation to the lungs. Barnard designed the idea of the heterotopic (or "piggy back" transplant) in which the patient's diseased heart is left in place while the donor heart is added, essentially forming a "double heart". Barnard performed the first such heterotopic heart transplant in 1974.<ref name="South-African-Medical-Journal-2012" /><ref name="Postgrad-Medical-Journal-2016">[http://pmj.bmj.com/content/early/2016/07/27/postgradmedj-2016-134309.extract "A tale of two hearts"], ''Postgrad Medical Journal'', 27 July 2016. "... HHT [Heterotopic Heart Transplantation] involves transplanting the donor heart without removing the recipient heart, effectively forming a 'double heart'. It was widely used in the pre-cyclosporine era when the donor was not strong enough (eg, the recipient had a much larger body) or the recipient had pre-existing pulmonary hypertension. Christiaan Barnard performed the first HHT ('piggy back' transplant) in 1974 ..."</ref>

From November 1974 through December 1983, 49 consecutive heterotopic heart transplants on 43 patients were performed at Groote Schuur. The survival rate for patients at one year was over 60%, as compared to less than 40% with standard transplants, and the survival rate at five years was over 36% as compared to less than 20% with standard transplants.<ref name="South-African-Medical-Journal-2012" />

Many surgeons gave up cardiac transplantation due to poor results, often due to [[Transplant rejection|rejection of the transplanted heart]] by the patient's immune system. Barnard persisted until the advent of [[ciclosporin|cyclosporine]], an effective immunosuppressive drug, which helped revive the operation throughout the world. He also attempted [[xenotransplantation]] in two human patients, utilizing a baboon heart and chimpanzee heart, respectively.<ref>{{Cite journal |last1=Barnard |first1=C.N. |last2=Wolpowitz |first2=A. |last3=Losman |first3=J.G. |date=1 December 1977 |title=Heterotopic cardiac transplantation with a xenograft for assistance of the left heart in cardiogenic shock after cardiopulmonary bypass |journal=South African Medical Journal |volume=52 |issue=26 |pages=1035–1038 |pmid=416502 |hdl=10520/AJA20785135_18333}}</ref>