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Norman Shumway

BMJ 2006; 332 doi: (Published 02 March 2006) Cite this as: BMJ 2006;332:553

The father of heart transplantation and surgeon who performed the world's first heart-lung transplant

Norman Shumway, a surgeon at Stanford University, California, had been researching heart transplantation in animals for a decade when he announced, on 20 November 1967, that he was ready to carry out the first human heart transplant and was awaiting a suitable donor. The announcement received news coverage around the world. The following day, the South African Cape Times announced that a team at Groote Schuur Hospital was on standby to perform a heart transplant. South African surgeon Christiaan Barnard (obituary BMJ 2001;323: 696) had trained with Shumway in California, and he performed the world's first transplant on 3 December 1967. The patient survived for 17 days.

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Shumway, a mild mannered and modest man, felt relieved that he wasn't the first. He wanted to avoid the media spotlight and perform a series of 10 operations that he could report in a medical journal. He performed his first successful human heart transplant, and the world's fourth, on 8 January 1968, five weeks after Barnard took the world by storm. The patient was Mike Kasperak, a middle aged steel worker.

However, Shumway was wrong to think that the media would have lost interest. When the donor had been found for Mr Kasperak, a call went out to the operating room staff. One was at a wedding reception, and a local reporter answered the phone and alerted his editors. To Shumway's dismay, the transplant operation was global headline news, with journalists scaling the hospital walls.

About a hundred transplants were performed around the world over the next few months, with mostly disastrous results, and the public developed a sense of public revulsion towards them. For the next 10 years there was a moratorium on heart transplants—except at Stanford.

While Barnard was enjoying a playboy life and having affairs with Sophia Loren and Gina Lollobrigida, Shumway worked quietly on, overcoming technical problems. He applied himself to the careful selection of donors and recipients, made efforts to increase the donor pool, brought about improvements in organ preservation and in heart biopsies, and followed developments in antirejection drugs. When the rest of the world resumed transplants, Shumway rightly ascribed the turnaround to his “radical perseverance.”

He soon led the world both in the numbers of hearts transplanted, and—more importantly—in his success rate. By 1991 his department had performed 687 transplants in 615 patients. Over 80% of these were still alive five years later and the longest survival was 20 years.

Shumway also developed and performed the first heart and lung transplant. He found, using animals, that it was impossible to transplant lungs without also transplanting the heart. With his colleague Bruce Reitz, he performed the first human heart-lung transplant in 1981. The patient, advertising executive Mary Gohlke, lived for five years.

Shumway performed or oversaw 800 heart transplants. He also advanced the treatment of congenital heart malformations in children, and the treatment of aneurysms and valve disease in adults. He improved techniques for storing transplant hearts when they were in transit between hospitals.

Norman Shumway was born in Kalamazoo, Michigan, where his father kept a creamery, selling dairy products. He enrolled at Michigan University to study law and was drafted into the army two years later. The military gave him an aptitude test that indicated an interest in medical matters, and asked him to choose between medicine or surgery. He chose medicine and was sent to an army premedical training course at Baylor University in Waco, Texas. This did not lead to a formal qualification, but he qualified at Vanderbilt University, Tennessee, in 1949.

After he qualified he went straight into the surgical research programme of Dr Owen Wangensteen in Minnesota. Wangensteen was the US leader in surgical research in the Midwest, and many famous surgeons, including Christiaan Barnard, trained under him. Shumway researched the effects of cooling on the electrical activity of the heart for his PhD, which he was awarded in 1956. He interrupted his studies to serve in the US air force for two years.

A year later he moved to Stanford University in California and started his transplantation career. He was soon joined by another heart surgeon with an interest in transplantation, Richard Lower, a graduate of Cornell and Washington universities. In 1959 they successfully removed a dog's heart and sewed it back, and in December that year they performed the first successful experimental transplant, in a dog, proving it was technically possible and that the heart would function and the circulation would be maintained. The dog lived for eight days.

Shumway became chief of cardiothoracic surgery at Stanford in 1965, and served as head of department until his retirement in 1993. He also lectured and wrote extensively—there are 447 papers listed in PubMed, which does not capture everything—and trained surgeons from all over the world.

Divorced from his wife, Mary Lou Stuurmans, in 1951, he leaves a son and three daughters.

Norman Edward Shumway, chief of cardiothoracic surgery Stamford University Medical Center, California, United States, 1965-93 (b Kalamazoo, Michigan, 1923; q Vanderbilt University, Tennessee, 1949), died from lung cancer on 10 February 2006.

[Caroline Richmond]

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