T10.mp37:21
來自圖說英語
HEART TRANSPLANTS
On 3 December 1967 Dr. Christiaan Barnard transplanted the heart of a 24-year-old girl into the chest of a 50-year-old man. The operation caught the imagination of the world, and there was a story that a television company offered a million dollars for one single photograph of Washkansky's old heart.
But the optimism was short-lived. Eighteen days after the world's first heart-transplant operation, Washkansky died of pneumonia at his hospital in Cape Town. The main problem facing Christiaan Barnard was how to prevent the body's rejection of the new heart. Anti-rejection drugs, it turned out, also weakened the body's resistance to any disease-carrying germs which came its way. It was a side effect, but it killed the patient.
Within a few days of Washkansky's transplant, another operation was performed in the United States, by Dr. Adrian Kantrowitz. The recipient, a two-and-a-half-week-old baby boy, died six hours later. A month afterwards, at the Stanford University Medical Center in California, Dr. Norman Shumway carried out a third. But his patient lived only slightly longer.
By now optimism had given way to doubt. There were those who believed that the heart was the home of the soul and the thought of a heart being transplanted from one body to another caused them a great deal of pain.
Another question asked was, was it all worth the trouble and money that went into it if at the end of the day the patient died?
But these early misgivings were not shared by everyone, and, in May 1968, one of Britain's most eminent cardiac surgeons, Donald Ross, decided to perform the operation on 45-year-old Frederick West. For the patient, it was a last chance. He had already suffered several heart attacks, and there was little hope of his living much longer in his condition. As Mr. Ross said at the time: "If the patient has no other future short of this transplant, we think we are morally justified, in the present state of our knowledge, in doing it."
For the following five weeks, Mr. West said he felt like a new man. But 46 days after his operation, Britain's first heart transplant patient died.
It was a great ordeal for Mrs. West, but an even greater ordeal had been publicity. Hundreds of reporters from the newspapers, radio and television besieged the narrow road outside the Wests' home, all wanted a glimpse of the family whose breadwinner had made British medical history. "I used to be afraid to go outside the front door," Mrs. West recalled. "People would jump on you, and others would drive by in the car and point at the house. It was frightening. All I wanted to do was hide."
The poor record of survival, plus public reaction against the media's use of heart transplants for publicity (and perhaps also entertainment), gave rise to wave of anti-transplant feelings both in and outside the medical profession. After that heart transplants as good as ceased.
One man in America carried on the research. It was Norman Shumway, who taught Christiaan Barnard his transplant techniques, after spending 20 years experimenting on animals. Today the American is one of the few foremost heart-transplant surgeons in the world, having overcome many of the earlier problems, like rejection. His rate of success speaks for itself. Out of 143 operations in the past decade, 59 patients are still alive. One man continues to lead an active life after eight years with someone else's heart beating inside him. Eight patients have survived for over five years, and 70 per cent of all Shumway's transplant cases live for over a year.
Meanwhile, we have the testimony of Mrs. Josephine West, to whom the 46 extra days she had with her husband were priceless. "They were good times," she told a friend. "And Fred had no regrets. He said, if he died tomorrow, he'd really enjoyed himself. It was like seeing him as he used to look before his heart trouble. It was all worth it, and I'd do the same again."
心臟移植
1967年12月3日，克里斯蒂安·巴納德醫生把一位二十四歲姑娘的心臟移植到了一位五十歲男人的胸內。這一手術轟動了整個世界，據說一家電視公司曾出一百萬美元的高價來購買沃什坎斯基原來心臟的一張照片。
然而，人們不久就不再感到樂觀了，因為在這次世界首例心臟移植手術後的第十八天，沃什坎斯基在開普頓的一家醫院裡因肺炎而死去。現在，克里斯蒂安·巴納德所面臨的主要問題是，如何防止人體對新心臟的排斥。服用抗排斥異體藥物會削弱人體對入侵病菌的抵抗力。這種副作用能將病人致死。
沃什坎斯基心臟移植手術後沒幾天，美國的亞德里恩·坎特羅威茨醫生完成了另一例手術。這個出生僅兩週半的男嬰在接受手術六小時後便停止了呼吸。一個月後，在加利福尼亞州斯坦福大學醫學中心，諾曼·薩姆威醫生做了另一例心臟移植手術，但是，病人活的時間只比那個男嬰稍長一點。
至此，人們不再樂觀，反而疑慮重重。有些人認為，心臟是人的靈魂歸宿，一想到一個人的心臟移植到他人身上，就令人痛若不堪。
另一點疑問是，假如病人手術當天就命歸黃泉，那麼是否還值得花費人力財力進行這種手術呢？
但是，並不是所有人都懷有這種疑問。1968年5月，作為英國最著名的心臟外科醫生之一的唐納德·羅斯決定給四十五歲的弗雷德裡克·韋斯特進行心臟移植手術。對病人來講，這是最後一線希望，因為他的心臟病已發作好幾次，以他的病情，他的生命已沒有幾天了。正如羅斯先生當時所說：“如果除了做移植手術之外，病人別無出路，那麼我們認為，在現有的醫學條件下，施行這種手術在道義上是無可非議的。”
韋斯特先生說，在手術後的五週裡，他覺得自己像是另外一個人。可是，在手術後的第四十六天，這位首例接受心臟移植手術的英國人離開了人世。
這對韋斯特太太打擊不小，但是宣傳報道對她的打擊更為沉重。數百名報紙、電臺和電視臺的記者圍在韋斯特家外面的狹窄街道上，想親眼目睹這位創造英國醫學史奇蹟的當家人的家。韋斯特太太回憶說：“我當時很害怕出前門，人們會擁到你跟前，有人駕車路過，也會用手指一指這座房子。這太可怕了。我當時只想躲起來。”
由於手術後病人存活時間短，加之公共輿論反對新聞界利用心臟移植來進行宣傳（甚至娛樂），所以，醫學界內外掀起了一股反對心臟移植的浪潮。隨後心臟移植手術幾乎停止了。
然而，一個美國人卻在繼續進行這一研究。他就是在動物身上做了二十年的試驗，後來向克里斯蒂安·巴納德傳授心臟移植技術的諾曼·薩姆威。現在，他攻克了許多像異體排斥這類的早期的難題，是世界上少數幾個做心臟移植手術的先驅者之一。他的手術成功率就很具說服力。在過去十年裡接受手術治療的143位患者中，有59位仍然健在。有一位病人在靠別人心臟維持了八年生命之後仍然健壯地生活著。8位病人手術後活了五年多。百分之七十的接受薩姆威治療的病人存活時間超過一年。
同時，我們有約瑟芬·韋斯特太太作證。對她來說，和丈夫多呆的那四十六天是無比寶貴的。她對一位朋友說：“那是一段美好的時光。弗雷德毫不後悔。他說他即使第二天就離開人世，他也已經真正嚐到了生活的樂趣。他看上去和患病前沒有兩樣。這樣做完全值得，再做一次我也願意。”
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