HEART SURGERY

Evening Star, Issue 15514, 9 June 1914, Page 9

HEART SURGERY

ATTEMPTS TO TRANSPLANT

ORGANS OF THE BODY,

Tho remajkablo experiments of Dr Alexis Carrel, of the Rockefeller Institute for Medical Research, described in ' The Times,'- have aroused widespread interest among surgeons. Dr Carrel Was able, by means of rubberprotected forceps, or grippers, to cut off the circulation from the hearts of dogs, to open these hearts, treat surgically various diseases affecting them, and finally to stitch up the organs so that complete recovery took place. Each of these operations was carried oat within •the space of 2£ minutes, this being the limit of -time during which tho circulation can be suspended. Discussing tho experiments, a well-known anatomist said that'they were rendered possible by the extraordinary qualities of the heart muscle This was able to maintain and also to recover its rhythmic contractions often in most unfavorable circumstances. A frog's heart could, if cut out and placed in saline solution (diluted salt water of definite strength), be kept beating for a considerable time. The danger, he fancied, would bo the introduction of air into, the circulation. If air in any quantity entered the chambers of the heart it rendered of the contents impossible, and caused death. —Tho Heart Transplanted.— It is interesting to note that Dr Carrel's successful investigations on the heart mark the conclusion of a valuable series of experiments carried out by him in connection with this and other organs. In 1905 he published a paper—the joint work of himself and Dr C. C. Guthrie—in ' American Medicine,' in which was described the transplantation of the heart of a small dog from its normal site to a place in the neck of a larger animal. The beating of the heart ceased during the experiment. About an hour and fifteen minutes after this event the operation was far enough 'advanced to allow of circulation being re-establdshed, and within a short time blood was passing through the transplanted organ, which, however, remained inert. In the belief that probably the small blood-vessels which feed the heart muscle had got plugged (so that the heart was deprived of its nourishment) these were probed and cleared of some clofcs>. Then at once twitching of the muscles took place, and gradually spread over the whole organ. Within about an hour the transplanted heart was contracting regularly at the rate of 88 beats per minute (the dog's own heart beat at 130 per minute). The object of this, : experiment was, of course, to determine whether it might not be possible to replace a diseased organ by a healthy one (investigations of the same nature were carried out also on lungs and kidneys, arid even limibs, while in one instance transplantation of the head was actually attempted). It was found, however, that these grafts never M took," the rule beinjj that the organs of one animal will not live in the 'body of another. " "■" —Why Grafts of Organs Fail.—

The reason for this failure is probably to be found in the fact that the blood possesses power to destroy tissue which has not become acclimatised to it. "Autografts"—that is, transplantation of tissue from one part of the same body to another part—frequently do well; the kidney, for instance, of a dog, if removed and replaced in the animal's neck, will continue to functionate. Whether it may nof» : yet be possible to overcome the " hemolytic " or destructive power of the blood is a question upon which the future of the transplantation of organs depends. Having failed to achieve the replacement of a diseased heart by a healthy one, Dr Carrel turned his attention to the problem of curing heart disease. Heart and blood-vessel surgery had been practised in a small way since 1899, when Dorfler initiated the practice of stitching up wounded arteries with fine sdlk. The next step was tho introduction of a "splice," an engrafted segment, into a vessel. The object here was not so much a ngw piece as a support until Nature should have time to produce a solid union of her own. Excellent results were achieved in this direction—so much so, indeed, that Drs Leonard Hill and William Bulloch, in a preface to Dr Guthrie's recent work on 'Blood-vessel Surgery,' state that " tlvi experiments of Carrel and Guthrie bring within the realms of possibility, under favorable conditions of locality, the removal of an aneurism (dilatatio-'i of a blood-vessel) and the restoration of vascular continuity by the insertion of a sterilised graft taken from the post mortem room." It is recorded of one of these grafts (or, rather, bloodvessel splints) that before being inserted it was treated' with dilute ammonia, alcohol, and paraffin oil. Finally, as announced, success has now been achieved with the heart itself.