What really happened in the world's first human heart transplant in 1967?

On 3 December 1967 in Cape Town, the surgeon Christiaan Barnard transplanted the heart of an accident victim, Denise Darvall, into a 54-year-old man, Louis Washkansky. It was the world's first human-to-human heart transplant. Washkansky regained full consciousness and could talk with his wife, but he died 18 days later of pneumonia, largely brought on by the anti-rejection drugs that suppressed his immune system. So it was a first, but it was not a cure.

A heart transplant is a surgical procedure for patients with end-stage heart failure when other treatments have failed. As of 2018 the most common procedure takes a working heart from a recently deceased donor, most often after brain death, and implants it in the patient. Barnard built on techniques developed by two American surgeons, Norman Shumway and Richard Lower. An earlier attempt in 1964 had used a chimpanzee's heart, which beat for 60 to 90 minutes before the patient died.

The new problem was the body itself. The recipient's immune system will attempt to reject a transplanted heart even if the blood type matches, and the risk never fully goes away. Patients take immunosuppressive drugs for life. In 1968, around 100 transplants were done worldwide and only a third of the patients lived longer than three months, so many medical centres stopped. The next big breakthrough came in 1983, when the drug cyclosporine entered widespread use.

Today about 5,000 heart transplants are performed each year worldwide, and survival periods average 15 years. A heart transplant is not considered a cure for heart disease; it is a life-saving treatment to improve the quality and duration of life.