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The Nasty Side of Organ Transplanting Norm Barber

The Nasty Side of Organ Transplanting Norm Barber

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Published by: vasiliki on Apr 01, 2011
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The Nasty Side of Organ Transplanting
 Norm Barber
The Nasty Side of Organ Transplanting
 
Second EditionNorm Barber 
 
C
hapter 1An Invented Death
 Transplant surgeons, just like movie vampires andFrankenstein doctors, like their bodies fresh and not quitedead. They need beating hearts in perfect health fromwarm, soft bodies to make the transfer of organsworthwhile. Their initial legal problem was that thisprocess constituted murder of the donor.The imperative of developing an artificial concept of deathbecame apparent after Christiaan Barnard¶s historic hearttransplant in December 1967. Barnard proved that hearttransplants could be done, but had faced the problem of the risk of the donor heart damaging itself during thedying process.Louis Washkansky was the world¶s first human hearttransplant recipient. He was a Lithuanian Jew from thetown of Slabodka who was deported to the Crimea whenthe Russians said the Jews were German spies. Louis latermoved to South Africa and worked as a grocer.Denise Durval, the world¶s first heart donor,was hit by a vehicle while walking to her car from a fastfood shop in South Africa. Brain tissue began leaking fromher ear. Denise was dying. Her father consented to theremoval of her heart.
 
 
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Louis Washkansky, desperately living each day at a time,was on the operating table. Hovering surgeons in fullgown had opened up Denise, eagerly awaiting her heart tostop forever, but it kept vigorously beating.Christiaan Barnard was worried the slow process of Denise¶s death would ruin her strong heart. Her brain wasso damaged and a number of bodily functions were failingand Barnard was worried the heart in particular wouldsuffer damage before it stopped.When a person suffers what is called catastrophic braindamage the body temperature, blood pressure control,renal and endocrine function, and a variety of otherprocesses progressively malfunction before the body dies,and it is this dying process that can ruin the organs. Theheart is particularly vulnerable to damage during thisprocess.To avoid this natural shutdown medical technicians mayinject a cardioplegic solution into the heart while it is stillbeating in the donor body. This action immediately stopsthe heart thus minimising the damage it may sustain asdeath progresses. The injection also gives it a longer shelf life before it is sewn into the recipient. It also kills thepatient. Barnard couldn¶t do this in 1967 in South Africabecause he would have been charged with murder.When Denise¶s heart finally stopped, there wasconfusion in the operating rooms. Incredibly, ChristiaanBarnard thought his brother Marius, also a surgeon, wouldremove the heart and he, Christiaan, would transplant it.It was resolved that Christiaan would do both, but by thetime he removed Denise¶s healthy, pink heart it haddeclined to a morbid greyish-blue. It was put into a dishand taken to the anaesthetised Washkansky waiting in the
 
 
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next room. There was a feeling of pessimism and doubtthat this heart could be restarted.But Barnard recounts that after a few electrical shocks,Denise¶s heart began beating strongly and pumpinglifesaving blood throughout Washkansky¶s body, but hedied anyway, eighteen days later.The autopsy of Louis Washkansky¶s body showed thatDenise¶s heart had transplanted perfectly and, despite thepatient¶s death, surgeons around the world rejoiced at theworld¶s first successful human heart transplant. But therewas still another problem.The South Africans had been lucky, but heartdamage would likely still occur during future donor deathprocesses, so it would be necessary to paralyse andremove the heart before it stopped naturally. The otherproblem was that in South Africa and most othercountries, this was considered murder. Transplantsurgeons, the medical hierarchy and drug companiesneeded a remedy to meet the demands of this brave newmedical advance.An Invented DeathAfter the Washkansky transplant, the HarvardMedical School set up an Ad Hoc Committee to Examinethe Definition of Brain Death²or, rather, to invent a newstyle of death.This committee of thirteen neurologists,neurosurgeons, lawyers, philosophers and an anaesthetistdecided in August 1968 that death could be proclaimed if a patient failed to respond to a series of reflex tests. Theycalled it the Harvard Criteria of Brain Death Test. Thisallowed a patient with a healthy, beating heart and fullyoperating renal and endocrine system to be defined asdead, just like a cold corpse. 2

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