Adrian Kantrowitz

Adrian Kantrowitz (October 4, 1918 – November 14, 2008) was an American cardiac surgeon whose team performed the world's second heart transplant attempt (after Christiaan Barnard) at Maimonides Medical Center in Brooklyn, New York on December 6, 1967. The infant lived for only six hours. At a press conference afterwards, Kantrowitz emphasized that he considered the operation to have been a failure.

Early life and education Adrian Kantrowitz was born in New York City on October 4, 1918. His mother was a costume designer and his father ran a clinic in the Bronx, and his grandparents were from Vermont. Adrian told his mother as a three-year-old that he wanted to be a doctor, and as a child built an electrocardiograph from old radio parts, together with his brother Arthur. He also developed a device that allowed individuals who were paralyzed to have their bladders empty through a signal sent from a radio-controlled device. In an October 1959 lecture at the American College of Surgeons, Kantrowitz and colleague Dr. William M. P. McKinnon reported on a procedure in which a portion of muscle from the diaphragm was used to create a "booster" heart to help pump blood in a dog, taking over as much as 25% of the pumping burden of the natural heart. The booster heart functions by receiving a signal sent by a radio transmitter triggered by the pulse of the natural heart. Kantrowitz noted that the procedure was not ready to be performed on humans. Ruff, a "friendly dog of unknown ancestry" was honored by the New York Academy of Sciences as "research dog of the year" for his unwitting participation in the implantation of a booster heart 18 months earlier in a procedure performed by Kantrowitz.

In the early 1960s, Kantrowitz developed an implantable artificial pacemaker together with General Electric.

Throughout the 1960s, he collaborated with a team that included his brother, engineer Arthur Kantrowitz, on the development of a left ventricular assist device. Building on his experiments with dogs, he performed the world's second permanent partial mechanical heart implantation in a human on February 4, 1966, which was successful, though the patient died 24 hours after surgery as a result of preexisting liver disease. His second implant of a partial mechanical heart on a 63-year-old woman, on May 18, 1966, lasted 13 days, until the patient died of a stroke.

As part of Kantrowitz's research for this project, he conceived of ABO-incompatible heart transplantation,

Worldwide context of heart transplantation Dr. James Hardy had performed the world's first heart transplant attempt and first heart xenograft at the University of Mississippi Medical Center on January 24, 1964. Since there was no standard of brain death, Hardy had acquired four chimpanzees as potential back-up donors. A comatose Boyd Rush with a faint pulse had been brought to the hospital several days earlier and when he went into shock and was taken into surgery, Hardy polled the fellow doctors on his team, with three voting yes and one abstaining. Hardy and his team then proceeded with the transplant using a chimpanzee heart which beat in Rush's chest approximately 60 to 90 minutes (sources vary), and Rush died without regaining consciousness. The hospital's public relations department put out a guarded statement, with many of the early newspaper articles making the assumption that the donor was a human. In addition, when Hardy attended the Sixth International Transplantation Conference several weeks later, he was treated with "icy disdain." Hardy withdrew from active pursuit of a successful heart transplant.

In what turned out to be a four-way race between South African cardiac surgeon Dr. Christiaan Barnard and Americans Norman Shumway and Richard Lower, Kantrowitz prepared for a potential human heart transplant by transplanting hearts in 411 dogs over a five-year period together with members of his surgical team. Barnard performed the first human-to-human heart transplant with an adult donor and recipient on December 3, 1967, at Groote Schuur Hospital in Cape Town, South Africa.

Worldwide, especially following Barnard's December 1967 transplant, there were more than 100 transplants were performed by various doctors during 1968. However, only a third of these patients lived longer than three months.

Kantrowitz's 1967 pediatric heart transplant attempt at Maimonides On December 6, 1967, at Maimonides Medical Center, Kantrowitz's team, including Bjørnstad PG, Lindberg HL, Smevik B, Rian R, Sørland SJ, Tjønneland S, performed the world's first pediatric heart transplant attempt as well as the first human-to-human heart transplant in the United States.

The donor David McIntire Bashaw who was anencephalic baby. His brain was "grossly malformed," and he had a poor Moro reflex (infant's startle response). However, Bashaw could move his extremities and had a feeble cry.

Some fundamentalist preachers raised theological issues with heart transplants. However, Bashaw's grandfather was well-known fundamentalist pastor Carl McIntire, and publicly countered the biblical arguments against it. At 3:45 a.m., the cooling procedure began.

The procedure According to Every Second Counts, both this infant and the recipient infant had their body temperatures cooled from 98.6 to 59 °F (from 37 to 15 °C), at which time surgeons then waited for the donor baby's heart to stop beating. At a press conference, Kantrowitz emphasized that he did not view the operation as a success.

Pump to assist heart The intra-aortic balloon pump was invented by Kantrowitz, working in conjunction with his brother, Arthur Kantrowitz. Inserted through the patient's thigh, it was directed into the aorta, and alternately expanded and contracted in order to reduce strain on the heart. Based on Kantrowitz's theory of "counterpulsation", the device inflated the balloon with helium gas when the heart relaxed and deflated it when the heart pumped blood. Since the device went into widespread use in the 1980s, it had been used in some three million patients by the time of his death. The patient became the first partial mechanical heart patient to be sent home, and died three months after the surgery.

Awards and honors Golden Plate Award of the American Academy of Achievement (1966)