On December 6, 1967, Dr. Adrian Kantrowitz and his surgical team at Maimonides Hospital in Brooklyn, New York, performed the first heart transplant in the United States, removing the heart of a anencephalic infant (born with no brain), and reconnecting it in a 19-day-old baby with an incurable heart defect. The recipient survived for only six and a half hours.
As a historic landmark, the event was overshadowed by the fact that three days earlier, the first heart transplant in the world had been carried out in Cape Town, South Africa, by Dr. Christiaan Barnard. It was thus Barnard who achieved immortality in the public consciousness, though Kantrowitz likely had the far greater impact on medicine – thanks to the more than 20 devices and other procedures he developed to prolong and improve the lives of cardiac patients.
Inventing a better headlight
Adrian Kantrowitz was born on October 4, 1918, in New York, and grew up in the Bronx. His father, Bernard A. Kantrowitz, was a Russian-born general medical practitioner with a Bronx clinic where patients could buy private insurance coverage for 10 cents a week. His mother was the former Rose Esserman, who had been a costume designer for the Ziegfeld Follies entertainment troupe.
As an adult, Adrian Kantrowitz commented that his mother had “told me from the age of 3 that I wanted to be a doctor.” Be that as it may, he showed a native interest and talent in science from childhood. He and his older brother Arthur – who grew up to be a physicist of some renown – assembled an electrocardiograph machine out of old radio parts. The two also put together a car headlight with a sensor that caused it to dim automatically when another car approached it.
Adrian attended De Witt Clinton High School and New York University, graduating in 1940 with a degree in mathematics. He received his medical degree three years later from the Long Island College of Medicine (today the SUNY Downstate Medical Center).
He followed that with an internship in neurosurgery, the field in which he intended to specialize, but after two years’ service as a battalion surgeon in the U.S. Army Medical Corps, in 1944-46, finding no residencies in neurosurgery, he took up general and thoracic surgery instead.
Secrets to extending life
During the 1950s and 1960s, Kantrowitz was one of several audacious surgeons who were experimenting with heart surgery. Their ultimate goal was not necessarily transplants, which were indicated only in cases where a patient’s heart seemed to be beyond repair, but rather a variety of measures and devices that could improve heart function and extend life.
First at Montefiore Hospital, in the Bronx, and later at Maimonides Medical Center, in Brooklyn, Kantrowitz was the first to insert a camera inside the heart of a living dog and film a beating heart. He invented an early implantable pacemaker; a heart-lung machine, which allowed for a bypass while repair surgery was being done to the heart; and two devices – the left ventricular assist device and the intra-aortic balloon pump -- that greatly assisted the function of damaged hearts.
Nonetheless, in the public mind, a heart transplant had the romance of a moon landing, and Kantrowitz was in a race with Dr. Barnard, in South Africa, on the one hand, and Norman Shumway and Richard Lower, at Stanford University, on the other, to be the first to reach that milestone.
On June 29, 1966, Kantrowitz almost was the first, but just as he was about to remove the heart from one brain-dead newborn for transplantation to an infant with congenital heart defects, two senior physicians at Maimonides stopped him, because the heart of the donor baby was still beating. Only later did brain death become the standard for determining death for purposes of transplants.
In 1970, Kantrowitz and 25 members of his team moved from Maimonides hospital to Wayne State University School of Medicine, in Detroit, a more fitting environment for the experimental work he continued with throughout his career. He and his wife, the former Jean Rosensaft, also established a company, LAVD, in 1983, to invent and build cardiovascular devices, and he was active there until his death, from heart disease, on November 14, 2008, at age 90.
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