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The Guardian - UK
The Guardian - UK
Politics
Tobi Thomas

History of transplant breakthroughs: from hearts to hands … and heads?

Heart and lung transplant machine
A heart and lung transplant machine at Papworth hospital in Cambridgeshire. Photograph: Sean Smith/The Guardian

Surgeons have performed the first womb transplant in the UK, it has been announced. The 34-year-old recipient received her sister’s uterus in an operation in February at Churchill hospital in Oxford that took nine hours and 20 minutes.

We look at some other major transplant breakthroughs over the years – and consider what the future may hold.

Heart and lungs

The first successful human heart transplant took place in Cape Town in South Africa in 1967. It was performed by the surgeon Christiaan Barnard on the patient Louis Washkansky, who died of pneumonia 18 days later.

In the UK, the first successful heart transplant took place in 1979 at the Royal Papworth hospital in Cambridge. The operation was performed by Sir Terence English on 52-year-old Keith Castle. Castle, who at the time of the operation was seriously ill, went on to live another five years.

Transplant surgery went from strength to strength and in 1983 the first combined heart and lung transplant was performed by Sir Magdi Yacoub at Harefield hospital. The Swedish journalist Lars Ljungberg underwent the transplant, receiving the organs of a woman from the south of England who had died the previous day.

Ljungberg survived for 13 days after the operation. The hospital said the heart and lungs he had been given had worked well and had not been rejected, but that he had died as a result of his pre-operation condition.

Face

In 2005, Isabelle Dinoire had the world’s first partial face transplant after her dog mauled her face while she had passed out having overdosed on sleeping pills. The surgery was performed by Prof Bernard Devauchelle at a hospital in France using using tissue from a brain-dead woman in a 15-hour operation at Amiens Picardie hospital.

For months before the transplant, Dinoire had said that she had “the face of a monster”. She had no mouth and her teeth and gums were exposed, skull-like, in a “reminder of death”. Most of her nose was missing. But she said she had no hatred for her dog Tanya, who she felt had been trying to save her.

Since Dinoire’s partial face transplant, more than 40 people worldwide have had similar surgery.

Hands

The first hand transplant took place in September 1998 in Lyon, France. A team of surgeons led by Jean-Michel Dubernard transplanted the right arm of a brain-dead donor on to Clint Hallam.

Although the 13-hour surgery was successful, Hallam was unable to psychologically cope with the new hand and stopped taking medication to prevent his body rejecting it. In 2001 the hand was amputated. Since then, more than 150 hand or upper limb transplants have been performed across the world.

The NHS performed the world’s first double hand transplant on Steven Gallagher after he was left unable to use his hands due to the condition scleroderma. Gallagher spent about four weeks in Leeds general infirmary after the operation in December 2021.

Sternum

In 2021 the first sternum transplant in the UK took place at the John Radcliffe hospital in Oxford. The procedure replaced the cancerous sternum of 34-year-old Nathalie Brett, who was diagnosed with stage four breast cancer when she was 24, with a healthy one from a deceased donor.

According to NHS Blood and Transplant, it is believed to be the first time such surgery had been performed in the UK, being a version of an operation that was carried out in Italy.

Possible future innovations

In 2019 Bruce Mathew, a former clinical lead for neurosurgery at Hull University teaching hospitals NHS trust, said the world’s first human head transplant could be achieved by 2030.

In an interview with the Telegraph, Mathew said: “It will take a number of advancements and incremental steps, but it will probably happen in the next 10 years.”

Researchers are also looking into the possibility of synthetic organ transplants, using organs produced with 3D bioprinting. In 2011, a synthetic windpipe made from nanocomposite materials was transplanted into a patient whose own windpipe was damaged by cancer.

In 2021, surgeons in New York announced that they had successfully transplanted a kidney grown in a genetically altered pig into a brain-dead human patient and found that the organ worked normally. The surgery was seen as a breakthrough in the field of cross-species organ transplants, which could eventually help save lives.

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