A pioneer organ transplant surgeon and investigator died on 20 February 2003. He was 84 years old and died of heart failure. In 1955, Dr. James D. Hardy was appointed the first chairman of the newly founded Department of Surgery at the University of Mississippi Medical School. He then began laboratory research in transplantation of the heart and lungs, using chimpanzees.
In 1964, he and his surgical team attempted the first human cardiac transplantation. The patient, a 64-year-old diabetic man with advanced heart disease, was intended to receive a human donor heart, but none was available. The concept of brain death for organ procurement had not yet been introduced, and procurement procedures were ill defined. As the patient's condition began deteriorating rapidly and death became imminent, Dr. Hardy procured a heart from a chimpanzee in the laboratory and proceeded with the transplant procedure. The donor heart reportedly beat on its own for 90 minutes but was inadequate in size to support the human adult body. Tissue rejection was highly likely.
The event brought criticism from all quarters—legal, ethical, moral, religious, financial, and governmental. Hardy defended his position because he believed that his laboratory research on primate organs justified this bold effort to prolong the life of a dying patient. The effect, however, was mostly negative on the developing field of organ transplantation. Three years later, in 1967, the first human-to-human cardiac transplantation occurred in Capetown, South Africa, but Christiaan Bernard used some of the technical and anti-rejection experience of Shumway and Lower.
Sheep, baboon, and chimpanzee hearts were transplanted into at least 4 adults, between 1964 and 1977. All died within 3½ days. In 1984, an infant known as Baby Fae received a baboon heart at Loma Linda University Medical Center in California, and she lived for 20 days.
After the failed chimpanzee transplant, Dr. Hardy continued research, and in 1987 his team transplanted a pair of lungs into a 29-year-old patient, leaving the heart in place. Whether Hardy's operation in 1964 was a stimulus or deterrent to the history of transplantation is debatable. Today, heterograft or xenograft procedures are not considered feasible and are seldom attempted, despite the availability of anti-rejection drugs such as cyclosporine. Most research in that field involves attempts at genetic modification and complex breeding techniques, using pigs. Clinical application is still remote.
Because of his determined scientific and academic approach, Dr. Hardy was able to salvage his professional reputation. He was a stimulating teacher who influenced the careers of many students and residents in his surgical department.
Fig. James D. Hardy, MD
(Courtesy of The University of Mississippi Medical Center, Office of Public Affairs)