/ 21 February 2005

Groote Schuur celebrates 500th heart transplant

The Christian Barnard Unit at Groote Schuur Hospital celebrated a milestone on Monday: the 500th heart transplant recipient to be released from the hospital.

”We try to keep the patient’s name confidential, but he is a male from Durban,” said Professor Johan Brink, cardio-thoracic surgeon and director of clinical services at the unit.

Brink said that from an initial success rate of only about 10 to 20% in the first years, heart recipients now lived an average of 10 years.

He said at one stage the unit held the world record for a patient surviving a heart transplant, a whopping 23 years.

Brink said heart surgery nowadays was ”relatively simple” with the major problem the question of immuno-suppression, or the use of drugs to prevent a body rejecting a transplanted organ.

Brink said most of the heart transplants performed were on males, where coronary artery diseases predominantly occurred.

”We’ve operated on four-year-olds and even 72-year-olds. Generally 65 is the cut-off [age],” he said.

Asked how budgetary cuts to tertiary high-care hospitals were affecting his unit’s work, Brink said their work was being made ”very difficult”.

”We want better support from the government… The idea of supporting tertiary hospitals seems to have slipped.”

Brink said the unit was very proud to celebrate its 500th heart transplant in trying conditions. He praised dedicated staff.

He said the Chris Barnard Unit — named after the South African pioneering surgeon who in December 1967, in a world first, transplanted the heart of a road accident victim into 59-year-old Louis Washkansky — were trend-setters until budgetary cuts started to bite in the late 1980s.

”It is difficult to stay with cutting-edge technology, such as artificial and mechanical devices. We can’t afford… the R1-million it costs for a mechanical heart device. It might not be appropriate in Africa to spend so much money on one person.”

Brink said the Groote Schuur Hospital unit, the country’s only public site, were world leaders in cheap heart transplants.

”We are incredibly cheap by international standards.”

Brink said the unit has been adversely affected by the brain-drain phenomenon, with many surgeons leaving for the private sector or relocating overseas.

He said the unit was trying to stem the tide. One measure was to establish a private hospital within the precinct of the public Groote Schuur hospital, in a bid to attract and maintain the services of staff.

”We are very proud of our heritage, of patient dedication and scientific enquiry,” said Brink. – Sapa