An organ from a road accident victim was given to a desperately ill 55-year-old man in Cape Town, South Africa. Louis Washkansky died 18 days later from the side-effects of powerful drugs used to prevent rejection.
But surgeon Christiaan Barnard had proved the operation could succeed. He became an overnight celebrity and started an era of transplants across the world. Last year in the UK alone almost 100 people received new hearts and the surgery causes barely a ripple.
Now Britain has its first hand transplant patient: Mark Cahill, a former pub landlord from Halifax. In an eight-hour operation at Leeds General Infirmary the 51-year-old, who lost the use of his right hand due to gout, was given a new one.
Mark, who can already wiggle his fingers, says: “I’m getting slight movement now. The feelings are starting to come back and everything’s looking very good. When I look at it and move it, it just feels like my hand.
The past few decades have seen remarkable strides in transplantation.
“I’m going to have a lot more use than I had on the existing hand so everything is a bonus. For a start I’ll be able to cut my food up, button my shirt, tie my shoelaces and mainly I’ll be able to hold my grandson’s hand.”
Of the moment he was asked to make history he says: “I went away and discussed it with my wife and thought, ‘Why not, let’s go for it’.”
The past few decades have seen remarkable strides in transplantation. The hand can be added to the list of body parts which includes the kidney, liver, bowel, cornea, lungs and pancreas. Overseas, donor legs have been successfully attached and medical pioneers are constantly trying to extend the boundaries.
In 1998 New Zealander Clint Hallam had the world’s first successful hand transplant at the Edouard-Herriot hospital in Lyon, France. But Hallam claimed it was like a dead man’s hand with no feeling and had it amputated in 2001.
In 1999 there was the first hand transplant with lasting success, on Mark Scott, an American who lost his hand in a firework accident.
Face transplants have achieved the most striking results. Isabelle Dinoire, a mother of two from Valenciennes, France, who had been mauled by a dog, had the first partial face transplant in 2005, receiving a suicide’s mouth and nose.
Five years later a team of 30 Spanish doctors performed the world’s first full face transplant on a farmer unable to speak or breathe properly after a shooting accident.
Last year American Richard Lee Norris, 37, whose face was destroyed in a shooting accident, received a new face, teeth, tongue and jaw in 36 hours of surgery involving a team of 100 medics. It’s believed to be the most extensive transplant ever performed.
For 15 years Mr Norris lived as a recluse in Hillsville, Virginia, hiding behind a mask and coming out only at night. He can now feel his face and brush his teeth and shave. He has also regained his sense of smell, lost after the accident.
The first leg transplant was in Spain three years ago. Surgeons gave the victim of a traffic accident in his 20s two legs, attaching first the bones then the tendons, arteries and nerves, after attempts to fit prosthetic limbs failed.
Dr James Neuberger, associate medical director for NHS Organ Donation and Transplantation, says: “Over the past three decades there have been huge changes in the way we operate. In the early days we talked in terms of one-year survival rates and even that was pretty dreadful for most transplants.
“Results have improved dramatically and we now measure survival in terms of 20 or 30 years. Transplants are a superb option for people with end-stage diseases and can transform lives.”
John McCafferty, 70, from Newport Pagnell, Bucks, is the UK’s longest surviving heart transplant patient. But he was given only five years to live when he had his operation in 1982 at Harefield Hospital, Middlesex.
According to Dr Neuberger there are three main reasons for these huge strides. With experience and the knowledge gained from those early, faltering days surgeons have become much more skilled.
Better drugs have been developed to reduce rejection and infection, which once claimed so many lives in the months after surgery.
There is now much improved matching of tissue and a protein called HLA which sits on the surface of the body’s cells. It’s also an important factor in rejection. Because surgeons now understand more about tissue matching – particularly important with skin which is very sensitive – fewer powerful drugs are needed. This reduces the likelihood of side effects, including some types of cancer. Latest work involves keeping donor organs viable for longer after they have been removed. Pumping fluids and blood into hearts, kidneys and livers mimics conditions in the body.
Last year Sweden saw the first womb transplant. The mother-to- daughter transplant paves the way for the recipient to give birth using the womb in which she was once carried.
Transplanting limbs poses a dilemma. Unlike hearts and other major organs a limb is not a matter of life or death. Artificial limbs are so good that they may be a better option because there’s no risk of rejection.
So, what breakthroughs can we expect in the next few years?
Some day we may use organs and tissue grown from our own stem cells. Research is in its infancy but it could be possible to grow an entire replacement heart or limb from scratch. Eventually it could be possible to keep healthy parts of the heart and re-grow just the damaged sections.
A development that seems straight out of science fiction is research into xenotransplantation, the use of genetically modified animals as a source for donor organs.
There are many hurdles. Dr Neuberger says: “The main problem with using animal organs, which is currently illegal in the UK, is rejection because of the different physiology of humans and animals.”
Techniques may be developed to allow surgeons to use a piece of donated living heart to grow a new one. So a son could donate part of his heart to his sick father.
Most challenging of all would be a brain transplant because of the many nerves in the head but Nadey Hakim, surgical director of the transplant unit at Imperial College London, advises caution.
“Sometimes there is a temptation to push boundaries too far,” he says. “In Turkey they tried to transplant two legs and two arms.
“It was folly to attempt it and the patient died. I know there have also been unsuccessful attempts to perform a head transplant on a dog. There is a limit.”
A shortage of donors is a major barrier to more transplants. Improvements in medicine, reluctance to carry donor cards and better safety on British roads have all contributed to the crisis.
Of the 7,500 people now on the waiting list for a transplant about a third will die before a donor organ becomes available.