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Transplant Medicine Agreed: Most thoughtful spokesmen stressed cautious progress, careful retrospective evaluation, and perhaps a limit on the number of heart transplants. Helen Taussig, distinguished heart pioneer, recalled early days of open-heart surgery when many small hospitals undertook this very complicated technique in an ill-advised rush into the field of newest surgical success. Everyone connected with transplant medicine agreed that the pure surgical technique for performing cardiac transplants had been mastered.
The most compelling difficulties, however, are more immediate and revolve about biological individuality, a chauvinism of the body. Each living organism is a discrete entity, wholly itself and no other. This aspect of "self" has a deep-seated biochemical base that evolved with each organism. It enables the organism to identify as "non-self" any intruder, whether or not potentially harmful. This blessing, which is called the rejection process, becomes a curse in transplant surgery. The body's normal rejection response to "non-self" must be subdued or circumvented to allow the transplant to take.
Before we can discuss Tissue and organ transplants in their proper context, we must first consider the vocabulary that is peculiar to this branch of medicine. All transplants are basically grafts, in which two parts are joined together. Grafts are identified by the biological closeness of donor and recipient.
In March he was able to report that replies received from 150 physicians; deans of schools of medicine, law, and theology; social scientists; and public administrators had yielded 137 statements of support and only 13 in opposition.
At later hearings, however, it was clear that many of those in opposition were those most directly concerned with the problem—the experimenters themselves. One of the most vociferous opponents was Christiaan Barnard, a physician from the Republic of South Africa, who had conducted the world's first human heart transplant. |
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