Surgery: Cape Town's Second

Like most South Africans, regardless of color and social status, Clive Haupt was stirred by Louis Washkansky's heart transplant. When Washkansky died, Garment Worker Haupt, 24, said to a neighbor: "I hope the next transplant succeeds." If the statement was obvious and unremarkable then, it soon gained poignancy. For the next transplant involved Haupt's own heart.

While Surgeon Christiaan N. Barnard was visiting the U.S. during Christmas week, he got reports from Cape Town that the patient next in line for a transplant, Philip Blaiberg, 58, was getting weaker. Several coronary occlusions had compelled Blaiberg to give up his practice as a dentist and caused irreparable damage to his heart, which was steadily failing. On Dr. Barnard's return, the transplant team at Groote Schuur Hospital was ready. So was Blaiberg, who insisted that he wanted the next transplant even when Barnard told him of Washkansky's death. But where would the heart come from? And would it come soon enough for a man who was clearly going downhill?

Color & Consent. It was a hot New Year's Day when Clive Haupt and his bride of three months went with friends to Fish Hoek Beach. Haupt played pickup rugby, then lay down to rest. Suddenly a friend called that Haupt was ill, with frothy blood coming from his mouth. From a local hospital, he was shuttled fast to the better-equipped Victoria Hospital, where doctors concluded that he had suffered a stroke—a massive brain hemorrhage. They saw little hope that he could survive. But since Haupt had apparently been fit, his heart was probably in good condition, so they telephoned the surgeons at Groote Schuur, who did not hesitate to say "Bring him in."

Dr. Barnard now had a delicate problem. Haupt was of a complicated racial mixture (part white, part Bantu, part Malay, perhaps even part Hottentot) that is classified as "Colored" under South Africa's race laws. Dr. Barnard asked Blaiberg whether he would object to receiving a Colored man's heart. No, replied the desperate patient—who, like Washkansky, happened to be Jewish. Then the surgeons had to get consent from Haupt's next of kin. His wife Dorothy collapsed when she was told he could not survive. To protect themselves, the doctors asked Haupt's mother. Widowed three years ago (her husband died of a stroke), she agreed to donate her son's heart.

While Haupt lingered through the night, pathologists and hematologists compared his blood type and cells with Blaiberg's. By a 12-to-l chance, both had type B, Rh-positive. Droplets of serum containing Haupt's white cells were pipetted onto dime-size disks in a plastic tray, each disk containing a cell-reagent preparation. The intensity of the reactions on different disks was noted, and compared with those already obtained from Blaiberg's cells. The cells, concluded Pathologist Martinus C. Botha, were a fairly good match. Not identical—that is impossible—but similar enough to suggest that Blaiberg's rejection mechanism would not react too strongly against a transplant.