Bruno Reichart
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Bruno Reichart (born 18 January 1943) is a retired German cardiothoracic surgeon who performed Germany's first successful
heart transplant A heart transplant, or a cardiac transplant, is a surgical transplant procedure performed on patients with end-stage heart failure when other medical or surgical treatments have failed. , the most common procedure is to take a functioning heart ...
in 1981 and its first combined heart–lung transplant in 1983. In 1984, he succeeded
Christiaan Barnard Christiaan Neethling Barnard (8November 19222September 2001) was a South African cardiac surgeon who performed the world's first human-to-human heart transplant operation. On 3 December 1967, Barnard transplanted the heart of accident victim ...
at
Groote Schuur Hospital Groote Schuur Hospital is a large government-funded teaching hospital situated on the slopes of Devil's Peak (Cape Town), Devil's Peak in the city of Cape Town, South Africa. It was founded in 1938 and is famous for being the institution where ...
in Cape Town and was appointed president of the International Society for Heart and Lung Transplantation (ISHLT) from 1988 to 1990. He returned to Munich in 1990 as director of the Cardiac Surgery Clinic at the Klinikum Großhadern of the University of Munich (LMU). He has also been active in experimental research in
xenotransplantation Xenotransplantation (''xenos-'' from the Greek meaning "foreign" or strange), or heterologous transplant, is the transplantation of living cells, tissues or organs from one species to another.primates Primates is an order of mammals, which is further divided into the strepsirrhines, which include lemurs, galagos, and lorisids; and the haplorhines, which include tarsiers and simians ( monkeys and apes). Primates arose 74–63  ...
, with a team involving
veterinarians A veterinarian (vet) or veterinary surgeon is a medical professional who practices veterinary medicine. They manage a wide range of health conditions and injuries in non-human animals. Along with this, veterinarians also play a role in animal r ...
, virologists, clinicians, lawyers and ethicists.


Early life and education

Bruno Reichart was born in Vienna in 1943 and grew up in
Ingolstadt Ingolstadt (; Austro-Bavarian language, Austro-Bavarian: ) is an Independent city#Germany, independent city on the Danube, in Upper Bavaria, with 142,308 inhabitants (as of 31 December 2023). Around half a million people live in the metropolitan ...
. He studied medicine at the
University of Erlangen–Nuremberg The Friedrich-Alexander University of Erlangen-Nuremberg (, FAU) is a Public University, public research university in the cities of Erlangen and Nuremberg in Bavaria, Germany. The name Friedrich-Alexander is derived from the university's first ...
and
Munich University The Ludwig Maximilian University of Munich (simply University of Munich, LMU or LMU Munich; ) is a public university, public research university in Munich, Bavaria, Germany. Originally established as the University of Ingolstadt in 1472 by Duke ...
, now called Ludwig Maximilian University of Munich (LMU) and received his MD in 1968, after which he became a medical assistant at the First Gynecological Clinic of the University of Munich, the Surgical Department of the Municipal Hospital Munich-Harlaching and at the Medical Clinic of the University of Munich.


Early surgical career

From 1971 to 1973, Reichart worked as a surgical assistant under surgeon Rudolf Zenker and within a year was appointed visiting cardiac physician in Memphis, Tennessee, where he focused on heart, lung, and
vascular surgery Vascular surgery is a surgical subspecialty in which vascular diseases involving the arteries, veins, or lymphatic vessels, are managed by medical therapy, minimally-invasive catheter procedures and surgical reconstruction. The specialty evolve ...
. Upon his return to Munich in 1974, Reichart commenced surgery at the Cardiac Surgery Clinic at the LMU. In 1977 he became its senior physician and a year later he passed his
habilitation Habilitation is the highest university degree, or the procedure by which it is achieved, in Germany, France, Italy, Poland and some other European and non-English-speaking countries. The candidate fulfills a university's set criteria of excelle ...
with the topic "The mechanical support of acute right heart failure", and become a cardiothoracic surgeon in 1978.


Heart transplant 1981

On 19 August 1981, Reichart performed Germany's first successful heart transplant at the LMU. The procedure was previously performed more than 10 years earlier in 1969, when two heart transplants took place in the Cardiac Surgery Clinic at the LMU, but they were both unsuccessful, with one dying within two days of surgery, from a
coronary thrombosis Coronary thrombosis is defined as the formation of a blood clot inside a blood vessel of the heart. This blood clot may then restrict blood flow within the heart, leading to heart tissue damage, or a myocardial infarction, also known as a heart ...
. Reichart's attempt in 1981 involved a 32-year old recipient who had experienced a
heart attack A myocardial infarction (MI), commonly known as a heart attack, occurs when Ischemia, blood flow decreases or stops in one of the coronary arteries of the heart, causing infarction (tissue death) to the heart muscle. The most common symptom ...
a year earlier and was left with severely impaired left ventricular function. During the year until heart transplant, the recipient also experienced a large blood clot in the lung, acute heart failure and a
stomach ulcer The stomach is a muscular, hollow organ in the upper gastrointestinal tract of humans and many other animals, including several invertebrates. The Ancient Greek name for the stomach is ''gaster'' which is used as ''gastric'' in medical terms re ...
. The 23 year old donor had been killed in a road traffic accident ten days prior to transplant.
Azathioprine Azathioprine, sold under the brand name Imuran, among others, is an immunosuppressive medication. It is used for the treatment of rheumatoid arthritis, granulomatosis with polyangiitis, Crohn's disease, ulcerative colitis, and systemic lupus er ...
,
cortisone Cortisone is a pregnene (21-carbon) steroid hormone. It is a naturally-occurring corticosteroid metabolite that is also used as a pharmaceutical prodrug. Cortisol is converted by the action of the enzyme corticosteroid 11-beta-dehydrogenase ...
and
Anti-thymocyte globulin Anti-thymocyte globulin (ATG) is an infusion of horse or rabbit-derived antibodies against human T cells and their precursors (thymocytes), which is used in the prevention and treatment of acute rejection in organ transplantation and therapy of ...
were the
immunosuppressants Immunosuppressive drugs, also known as immunosuppressive agents, immunosuppressants and antirejection medications, are drugs that inhibit or prevent the activity of the immune system. Classification Immunosuppressive drugs can be classified ...
used until two rejection episodes resulted in changing therapy to cyclosporine A three weeks after surgery and they were discharged from hospital at Christmas 1981. Between 1978 and 1982, he held various professorships including the Universities of Boston, Birmingham, Milwaukee, Paris and Stanford. More than twenty heart transplant procedures followed over the next three years. Under his leadership, intermittently spanning over 40 years at LMU, more than 1,000 heart transplants were performed.


Combined heart-lung transplant 1983

On 13 February 1983, Reichart was the first in Germany to perform a combined heart–lung transplant. The recipient was 27 years old and bed-bound with severe
pulmonary hypertension Pulmonary hypertension (PH or PHTN) is a condition of increased blood pressure in the pulmonary artery, arteries of the lungs. Symptoms include dypsnea, shortness of breath, Syncope (medicine), fainting, tiredness, chest pain, pedal edema, swell ...
and diseased liver and kidneys. The donor, three years younger, had died the previous day from a clot in the brain. Following the combined heart–lung transplant, the recipient died after ten days. Reichart was appointed professor at the LMU in the same year.


Later surgical career

In 1984 he became a cardiac surgeon at the South African
Groote Schuur Hospital Groote Schuur Hospital is a large government-funded teaching hospital situated on the slopes of Devil's Peak (Cape Town), Devil's Peak in the city of Cape Town, South Africa. It was founded in 1938 and is famous for being the institution where ...
in Cape Town, succeeding
Christiaan Barnard Christiaan Neethling Barnard (8November 19222September 2001) was a South African cardiac surgeon who performed the world's first human-to-human heart transplant operation. On 3 December 1967, Barnard transplanted the heart of accident victim ...
. Here, his research on baboons and green monkeys had been discontinued due to problems with its acceptance from society and the universities. In 1990, he returned to Munich and was appointed director of the Cardiac Surgery Clinic at the Klinikum Großhadern of the LMU.


Xenotransplantation

In 2011, he became a spokesman for funded research into the transplantation of pig tissue and organs into primates (xenotransplantation,) leading a group that develops
transgenic A transgene is a gene that has been transferred naturally, or by any of a number of genetic engineering techniques, from one organism to another. The introduction of a transgene, in a process known as transgenesis, has the potential to change the ...
pigs. To prevent hyperacute rejection and coagulation disorders, harmful pig genes are replaced with certain human genes. This German Research Foundation (DFG) funded research, the “Biology of xenogeneic cell, tissue, and organ transplantation – from basic research to clinical application” has involved collaborating with
veterinarians A veterinarian (vet) or veterinary surgeon is a medical professional who practices veterinary medicine. They manage a wide range of health conditions and injuries in non-human animals. Along with this, veterinarians also play a role in animal r ...
, virologists, clinicians, lawyers and ethicists. At his 75th birthday celebrations in 2018, he anticipated that it would take at least three years before the first human would be implanted with a pig's heart. His aspiration is to see that "the transplanted tissues and organs will in the future be genetically programmed to also carry an immunosuppressive molecule on all their cells, so that even fewer corresponding drugs are needed - or perhaps none at all".


Awards and honours

Reichart was president of the ISHLT from 1988 to 1990,Past Presidents.
International Society for Heart and Lung Transplantation. Retrieved 8 July 2018.
who honoured him with the Pioneer Award for his work in heart surgery in Munich at their 35th annual meeting in 2015. He holds emeritus membership of the society.


Selected publications


Books


''Crossing the Borders in Heart Surgery: Simple Thoughts''
University of Cape Town The University of Cape Town (UCT) (, ) is a public university, public research university in Cape Town, South Africa. Established in 1829 as the South African College, it was granted full university status in 1918, making it the oldest univer ...
, 1985, .


Articles

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References

{{DEFAULTSORT:Reichart, Bruno German thoracic surgeons German transplant surgeons Living people 1943 births University of Erlangen–Nuremberg alumni Ludwig Maximilian University of Munich alumni Academic staff of the Ludwig Maximilian University of Munich History of heart surgery History of transplant surgery 1981 in medicine 1983 in medicine