BOOK OF THE WEEK
SPARE PARTS: A SURPRISING HISTORY OF TRANSPLANTS
by Paul Craddock (Fig Tree £18.99, 320pp)
An Indian woman who had lost both her hands in a 2016 traffic accident was given a new pair, taken from a man who had just died.
The transplant was successful — so much so that over the next 18 months, the hands actually changed colour, becoming lighter to match the woman’s own skin tone. They also started to show ‘feminine features’.
Experts aren’t entirely sure why, but then as the rest of this book shows, transplanting body parts has often been an uncertain science. The idea that we might be able to benefit from other people’s ‘cast-offs’ goes way back — ancient Romans used to eat gladiators’ livers to try and take on their powers.
But more reasoned approaches took centuries to emerge.
Paul Craddock explores the origins of transplant surgery in a fascinating new book, as it’s revealed scientists at University College London, think we might be a decade away from the 3D printing of entire body parts (file image)
The first body part in play was the nose. People who’d lost their own to disease or injury sometimes wore false ones attached to spectacle frames. The Vianeo brothers of 16th-century Italy thought there had to be a better way, so pioneered an operation where skin was taken from a patient’s arm and fashioned into a new nose.
To keep the skin alive as it ‘took’ to the face, they left it attached to the arm by a small flap, meaning that you had to spend days with the two body parts connected before the operation could be completed.
Teeth were relatively simple. Or at least taking them out was — indeed, in 18th-century Paris tooth drawers operated as street performers. One flicked out patients’ troublesome molars from the back of his horse using the point of a sword, while another used just his fingers, but did so accompanied by violins and dancing girls.
British dentist John Hunter noticed the roots of extracted teeth resembled the lizard tails he’d experimented on as a younger man, which he would pluck off to see whether new ones would grow back (they did).
Would a tooth ‘grow into’ a new gum? Hunter had some success, and soon poor people, who couldn’t afford sugar and therefore had healthy teeth, were selling them to dentists for transplantation into rich people’s mouths.
However the operation didn’t always work — some patients even died — so by the 19th century the practice was abandoned.
At least Hunter meant well. The 1920s charlatan John Brinkley claimed to cure ‘sexually weak’ male patients in the U.S. state of Kansas by grafting goat testicles onto them. In reality all he did was tuck tiny pieces of said animal’s testicles under the skin of the men’s scrotums.
Exposed as a fraud, Brinkley was eventually declared bankrupt.
Christiaan Barnard carried out the world’s first heart transplant in 1967. Pictured: South African surgeon Christiaan Barnard performing heart surgery in 1977
Before any real progress could be made on transplanting internal organs, doctors had to solve the problem of stitching together blood vessels. This was fitting, given the symbolic importance attached to blood ever since the Greek physician Galen of Pergamon had written about it in the 2nd century AD. He believed that the blood vessels in the third finger of your left hand led to your heart, which is why we now wear wedding rings there. (He was right, but only because all blood vessels lead to your heart.)
The French surgeon Alexis Carrell made great strides in the early 20th century: he learned sewing techniques from the woman who’d embroidered the curtains at the Paris opera house, then he practised on cigarette papers.
In 1908 he treated a newborn girl with a fatal blood disease by linking her veins to those of her father, so his healthy blood could flow into her body and save her. Carrell went on to attend the girl’s 21st birthday party.
Another hurdle was inventing machines that could do the job of failing organs as they were replaced. The first artificial kidney was made by Willem Kolff, a Dutch doctor, during World War II. It was housed in the frame of a downed German bomber plane and used sausage skin to filter the patient’s blood, which was pumped by a motor obtained from a Ford dealership.
Barnard (pictured) delayed the world’s first heart transplant by a week to ensure the recipient got his new heart from a white woman, as he wanted to avoid giving the impression that black lives were disposable
This made dialysis possible — the machine acted as a patient’s kidneys for a while, allowing the real ones to heal themselves. The first woman whose life was saved in this way woke up and said: ‘Now I’m going to divorce my husband.’
The first patient to get a new kidney from someone else was the American Richard Herrick, in 1954.
The donor was his twin brother Ronald. At the time it wasn’t known for sure whether someone could survive with just one kidney.
Knowing how much pressure Ronald would feel under to agree, Richard scribbled him a note from his hospital bed: ‘Get out of here and go home.’ But Ronald insisted, and the transplant was a success.
The most famous operation was the world’s first heart transplant, carried out by Christiaan Barnard in 1967. The South African could have performed the operation weeks earlier, but the donor heart would have come from a black man.
SPARE PARTS: A SURPRISING HISTORY OF TRANSPLANTS by Paul Craddock (Fig Tree £18.99, 320pp)
Barnard pretended there was a problem with the organ, but actually, as an opponent of apartheid, he wanted to avoid giving the impression that black lives were disposable.
In the end the recipient got his new heart from a white woman.
Future developments will be mind-boggling. Scientists at University College, London think we might be only a decade away from the 3D printing of entire body parts. We’ve already grown human heart tissue on the collagen ‘scaffold’ of a spinach leaf.
But Paul Craddock isn’t concerned simply with the science — he also tackles the philosophical side of things. Until the 18th century, people worried that transplants ‘might alter who they inescapably were, change their predestined and pre-designed selves’.
But the French philosopher Julien Offray de La Mettrie argued that the human body is simply a machine, an argument that paved the way for moving body parts from one ‘machine’ to another.
Craddock’s experience of attending a transplant operation seems to marry the two views together.
As the clamps were removed from blood vessels, linking the replacement organ to its new body, ‘in a matter of seconds the kidney turned from grey to pink, then almost red. It seemed as if life itself had cascaded from one man’s body into another’s’.