Sudhir Choudhrie takes part in Science Museum debate on heart transplants.
Sudhir Choudhrie joined a panel of internationally renowned surgeons at the Science Museum to discuss the past, present and future of the heart transplant.
The event was staged as part of the commemorations for the 50th anniversary of the first heart transplant, which took place in South Africa on December 3rd, 1967. A display at the Science Museum, funded by the Choudhrie Family Foundation, was unveiled in December 2017.
Sir Terence English, who performed the UK’s first successful heart transplant, recalled how Professor Christiaan Barnard had “stunned the world” with the pioneering surgery. It inspired other surgeons to emulate him and 160 transplants were carried out by 50 units around the world from 1968-9, but they did not have the right support teams in place and the results were “appalling” with most patients dying within one month and only 10% surviving for two years.
By contrast, 200 transplants a year are today successfully carried out in the UK alone. Seventeen patients, who received a new heart more than 30 years ago, are still alive; one is still alive 36 years after his transplant. Sir Terence admitted he never would have anticipated that success rate when he carried out the UK’s first transplant in 1979 amid widespread scepticism and with no funding from the Department of Health.
His first patient died after just 17 days, but his second, a charismatic Cockney builder called Keith Castle, lived for five years and became a celebrity. It paved the way for specialist heart transplant units at Papworth and Harefield hospitals, followed by new centres at Newcastle, Manchester and Birmingham. Sir Terence contrasted that to the US where growth had been less controlled, with 120 transplant units set up.
Cardiothoracic surgeon Dr Mehmet Oz, who carried out a life-saving heart transplant on Mr Choudhrie at Columbia University Medical Center in New York in January 1999, said that the heart transplant was often a remarkably straightforward operation. However, he said Mr Choudhrie had been “in as bad a shape as you can imagine” when brought into the hospital and paid tribute to the strength and support of his wife, Anita.
Dr Oz said the emotional support offered by a patient’s family was crucial to the success of an operation: “Your heart needs a reason to keep on beating”. He said this should be more widely acknowledged in the medical profession and the acronym STEM (Science, Technology, Engineering and Mathematics) should be changed to STEAM, incorporating the Arts, which bring a different perspective to medicine. “Artists look over the chasm of the orderly world we want to live in and see the chaos: they alert us to it, but also see the possibilities it offers”.
Pedro Catarino, consultant cardiothoracic surgeon at Royal Papworth Hospital, gave a glimpse of the future of heart surgery. Forty-six transplants have been carried out at the hospital using a new technique, taking the heart from a circulatory determined dead donor (DCD) – a person confirmed dead because their heart had stopped beating. Until recently, surgeons have only been able to use the heart from a donor following a diagnosis of brain death (DBD).
It was assumed that it would be impossible to take a heart that had stopped and use it to keep someone else alive. But, using the new technique, the heart is placed on a pump. Blood is taken from the donor themselves and pumped around an oxygenator and into the heart, which is resuscitated over a period of around two hours. The heart is placed into a Transmedia Organ Care System (OCS) – nicknamed the ‘heart-in-a-box – for transportation.
Ninety-two per cent of patients, who received new hearts using this technique, have survived for at least a year, a comparable figure to transplants using the heart of a DCD. The significance of the new technique is that it will greatly increase the number of hearts available for transplant – the shortage of donors has become an increasing problem in recent years.
The Choudhrie Family Foundation has supported a major campaign in the US, run by the charity Healthcorps, to recruit 62,000 new organ donors. Chairing the panel event, Dame Mary Archer, Chairman of the Board of Trustees at the Science Museum, hailed Mr Choudhrie as “an inspiration” for the way he had overcome serious heart disease and told his story in his book From My Heart.