Replacing the body's natural pump

During the four hours or so it takes the surgical team to remove a damaged heart and replace it with a new one, the patient is kept alive by a bypass machine, which does the job of pumping blood around the body, in the absence of our most hard­working muscle.

Your heart beats over 40 million times in a year. It’s been with you since the womb, and without it, blood ­ and therefore oxygen and nutrients ­ stops flowing. Until as recently as 1979, there were few options for those with heart disease beyond medication and palliative care in the final stages of failure. The situation was dire, and people were dying. In 1961, 166,000 people in the UK died from coronary heart disease (British Heart Foundation).

Then, in January 1979, 11 years after Professor Sir Roy Calne performed the UK’s first successful liver transplant, Sir Terence English and a team or surgeons at Papworth Hospital, successfully transplanted a heart from one person to another. A shortage of donors and the monumental challenges faced in terms of timing and organ rejection by the immune system, means that heart transplantation is still rare, relative to other organs. Between 2012 ­ 2013, there were 197 heart transplant operations in the UK, compared to an average of 715 liver transplantations.

How did we get here?

As far back as the early 1900s, doctors were realising that in order for a graft or a transplant to work, there needed to be a “blood relationship” between participants. Austrian physician Karl Landsteiner had discovered blood groups, and German biologist Paul Ehrlich was well on his way to explaining pathogens and antibodies.

Throughout the 1940s and 50s, the problem of rejection plagued surgeons attempting to successfully transplant hearts, and in the 1960s, even though valve operations were becoming commonplace, the recipient immune system remained too stubborn to make full transplantation viable.

It would be another decade until immunosuppressants had become refined enough to allow Sir Terence to successfully remove one heart, and replace it with another.

Surgeons at Papworth would go on to complete the UK’s first successful combined heart and lung transplantation, and the hospital continues to be the chosen treatment centre of the Royal Family.

For more information on becoming an organ donor visit the NHS Blood and Transplant website.

Explore further

A history of heart transplantation
Transplant surgery at Papworth Hospital
What happens during a heart transplant