NEW YORK — Dr Richard R. Lower, whose daring heart surgeries on animals in the 1950s helped pave the way for the first successful transplant of a human heart in 1967, died on May 17 in Twin Bridges, Montana. He was 78. The cause was pancreatic cancer, his family said.
As a surgical resident at Stanford University in 1959, Lower transplanted part of a dog’s heart to a second dog, which lived for eight days, shattering a previous survival record of seven hours. He was working with Dr Norman E. Shumway, who became a towering figure in cardiac surgery and eventually oversaw the transplanting of 800 human hearts.
One innovation was to leave in place sections of the recipient heart s upper chambers, which shortened the duration of the operation. But when an infection took hold, Lower and Shumway euthanised the dog and drew a prescient conclusion: That difficulties in transplants would no longer be technical or tied to problems in surgery so much as to conquering infection and the patient s immune response.
Lower (pronounced LAU-er) continued to experiment with animal transplants after moving to the Medical College of Virginia, in Richmond, in 1965. A rush to apply the procedure in human cases of severe cardiac disease and malfunction was inevitable, and a South African surgeon, Dr Christiaan N. Barnard, performed the first successful human heart transplant in 1967. Barnard had visited Lower s laboratory in 1966 and studied the Shumway-Lower approach and technique.
Lower declined an opportunity to perform an early heart transplant because of incompatibility of the blood types of the potential donor and recipient. Then, in 1968, he operated on a 54-year-old man, who died a week afterward. In the same year, Lower operated on a 43-year-old man, and that surgery proved to be highly effective the patient survived for 6 1/2 years.
Scientific caution and startling patient mortality reduced the pressure for transplants in the 1970s, although Lower and others continued to refine the procedure. At Stanford, Shumway combined the use of cyclosporin, an immunosuppressant drug, with an innovative biopsy technique that enabled him to readily check the body s acceptance or rejection of a new organ. In time, survival rates in the first year for transplant patients rose from roughly 60 per cent in the 1970s to nearly 90 per cent today. Transplant recipients have lived as long as 27 years after the surgery.
From 1968 until his retirement in 1989, Lower took part in 393 heart transplants and "persisted, along with Dr Shumway, when many others quit or doubted the procedure," said Dr Marc R. Katz, a cardiothoracic and transplant surgeon, and the medical director of Bon Secours Heart and Vascular Institute in Richmond. Katz, a former student of Lower, also said that he was instrumental in sending organ-harvesting teams to the hospitals of potential donors, in order to speed transplant schedules and in consideration of donors families. Before the late 1970s, he said, it was a common practice to send a donor s entire body to the recipient s hospital, a cumbersome process that was emotionally fraught for the donor s relatives. Richard Rowland Lower was born in Detroit. He graduated from Amherst College and earned his medical degree from Cornell University in 1955. He was an assistant professor of surgery at Stanford before moving to the Medical College of Virginia at Virginia Commonwealth University, where he was named a professor of surgery in 1967. He was also a former chairman of the college s division of thoracic and cardiac surgery.
Lower is survived by his wife of 55 years, Anne Rutherford. The couple lived in Richmond and Twin Bridges. A daughter, Hilary Richardson three sons, Gavin, Frederick and Glenn a brother, Frederick and six grandchildren also survive him.
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