125 Stanford Stories

NO. 35

World’s first successful heart-lung transplant

Stanford’s Dr. Bruce Reitz recalls leading the historic surgery

Stanford cardiothoracic surgeon Dr. Bruce Reitz led the team at Stanford Medical Center that performed the world’s first successful heart-lung transplant on March 9, 1981.

The procedure, on a 45-year-old newspaper executive named Mary Gohlke, solidified Stanford’s reputation as a leader in transplant surgery.

Looking back after 35 years, Reitz vividly remembers the historic procedure and key moments in its success.

While still a Stanford undergraduate, Reitz, ’66, was doing directed research on the immunological reactions of the heart. After medical school, he returned to Stanford to work with transplant pioneer Dr. Norman Shumway, who at Stanford in 1968 conducted the first successful U.S. human heart transplant on an adult. The two doctors began work on heart-lung transplantation in the 1970s, refining the procedure on dogs and monkeys.

Their progress was limited by the immunosuppressive drugs then available. Any drug strong enough to block rejection of the donor organ also suppressed surgical healing. By 1978, the European firm Sandoz had developed the drug cyclosporin A, which proved effective in Reitz’s primate trials. However, by late 1980 the U.S. Food and Drug Administration had approved it in humans only for heart transplantation.

Gohlke, diagnosed with primary pulmonary hypertension, had learned of Reitz’s research after the newspaper where she worked ran an article about it. She came to Stanford and waited in the hospital for federal action on cyclosporin A, her condition worsening.

In desperation one day, she phoned her paper’s editor, who phoned his U.S. senator. In an hour, Reitz remembers, he received word from the FDA clearing cyclosporin A for use in heart-lung transplantation at all qualified hospitals. The donor organs came from a San Diego teenager killed in a traffic accident.

The surgical team included Reitz, Shumway, and many others including Stanford’s Dr. Philip Oyer, who went on to co-develop and implant the first mechanical ventricular assist device, which prolongs patients’ lives as they wait for donor hearts. Reitz was just 36 years old.

“The appearance of Mary Gohlke’s totally empty chest was indeed a dramatic moment,” Reitz remembered. “I wondered, ‘Is this really going to work out?’

“But the implantation went smoothly, the heart resuscitated quickly, and lung function was adequate immediately.

“It was such a transformation for her! To take someone back from the brink of death and give them health — that’s one of the great things about transplant and about being involved in transplant.”

Gohlke lived for five years with her new heart and lungs, traveling and writing a book about her experience.

“Her spirit, courage, determination and, ultimately, her willingness to explore the unknown, to be the first, made possible the era of therapeutic lung transplantation,” Reitz said.

Stanford performed its 500th lung transplant in 2014. Today, it performs more heart-lung transplants than any other center in the United States, while Stanford’s Lucile Packard Children’s Hospital leads the nation in the number of all pediatric organ transplants performed annually.