Josef Wimmer (cardiac patient)

Josef Wimmer (born February 28, 1931 in Wörgl ; † November 15, 1986 in Innsbruck ) was the first person in 1983 to have a heart transplant in Austria .

biography

Profession and life until 1983

Josef Wimmer was a professional soldier and had completed the NCO career in the Austrian Armed Forces , in which he last held the rank of Vice Lieutenant . In 1983, when he was 52 years old at the time, he had developed considerably overweight (112 kg with a height of 183 cm) and was in the intensive care unit of the Kufstein hospital after several heart attacks . At this time, Wimmer was suffering from ischemic cardiopathy in the end-stage, so that the treating cardiologists no longer gave him a chance of survival. At the German Heart Center in Munich - the only heart transplant center in German-speaking countries at the time - Wimmer had been rejected as a patient due to pronounced pulmonary hypertension , but agreed to attempt an operation at Innsbruck University Hospital because he wanted to use all remaining medical options. According to Franz Gschnitzer , then head of the Innsbruck special department for cardiac surgery, the surgical procedure itself is the simplest part of a heart transplant; The greatest problems are obtaining a suitable donor organ and absorbing the rejection reactions in the recipient's body. Such defense reactions were only effective after the development of cyclosporine , which was first used in 1978 by Roy Calne at Cambridge University as an immunosuppressant in a transplant be reduced.

First heart transplant in Austria

State and University Hospital Innsbruck

On September 13, 1983, Wimmer was transferred to Gschnitzer's special department at Innsbruck University Hospital. On the morning of October 11th, the transplant team headed by Raimund Margreiter was informed by the hospital's intensive care physicians that there was a potential organ donor compatible with Wimmer's blood group and size in their department. It was about the 27-year-old student Albin Castelrotto from Wolfurt in Vorarlberg , who had been in a coma for a few days and had been brought to Innsbruck with Christophorus 1 , Austria's first civil rescue helicopter , which only went into operation on July 1, 1983 . Since the brain death diagnostics on the donor's body should be completed around 7 p.m., the removal of the heart was planned for 8 p.m. While Margreiter removed the heart from Castelrotto, Gschnitzer connected the patient Wimmer to the heart-lung machine so that the implantation could begin without delay.

On October 11, 1983 at 9:45 p.m., six doctors and 14 other employees began the transplant under the direction of Margreiter. In an eight-hour operation, the doctors implanted the second heart in Wimmer to support his own. The technique known as "piggyback transplantation" - in which the weakened heart remains in the body and a transplanted heart rests on top of the existing one for relief - was first used by Christiaan Barnard in 1974 . During the operation on Josef Wimmer, part of the donor's aorta was used to connect the donor and recipient pulmonary artery . At the end of the operation around 3 a.m., the patient came from the heart-lung machine without medication, which spoke for the excellent quality of the transplant , and no circulatory-supporting medication was necessary. Immediately after the operation, the attending doctors rated Wimmer's condition as “good under the circumstances”.

After the successful procedure, Wimmer lay in artificial deep sleep for three days . He then recovered quickly: three weeks after the operation he was able to start the first rehabilitation exercises, and five weeks after the transplant he made his first attempts at walking. On December 6, 1983 - 54 days after the operation - Wimmer was able to leave the Innsbruck University Hospital and return to Wörgl with his wife Ruth. In the next few years he did a lot of sport and traveled, and he also got to know the family of the heart donor Albin Castelrotto. Ruth Wimmer found the knowledge that he was the same age as her eldest son very stressful.

While Wimmer was undergoing medical rehabilitation , Margreiter's team in Innsbruck carried out the next heart transplant using the “piggyback technique” on February 5, 1984, during which a 28-year-old man with idiopathic cardiomyopathy was successfully operated on. He is currently (2016) the longest patient in Austria who has lived with a strange heart. The first orthotopic heart transplant took place in Innsbruck on February 22, 1984, but the recipient died 39 days later of a generalized Aspergillus infection.

Life 1983–1986 and media coverage

Wimmer and Margreiter became known throughout Austria for their heart transplants, Innsbruck surgery dominated the headlines for days and a real media hype set in . Margreiter later also reported that the morning after the operation he was presented with the latest edition of a high-circulation Austrian daily newspaper, the front page of which criticized the transplantation “in large letters” and described his team as incompetent. Since the editorial deadline was set for Wimmer before the operation began, the article must have been printed without the journalists' knowledge of the actual course of the operation.

In the months and years that followed, Wimmer and his family were regularly the subject of reports in the Austrian mass media, and the name of the heart donor was also mentioned frequently. Among other things, Wimmer was photographed skiing in the spring of 1984 and was a guest on the ORF television program Tritsch Tratsch . In the course of the program, Wimmer was asked by the presenter Joki Kirschner whether he believed in God after his serious illness, which he denied and referred to himself as an atheist . Wimmer then received numerous letters and phone calls in which he was heavily criticized for his testimony - some anonymously.

Second heart transplant and death

In 1986 Wimmer had to undergo another heart transplant at the Innsbruck University Hospital. Despite the treatment, the disease of his own heart had progressed further in the meantime, so that now, almost three years after the successful first operation, it had to be replaced by a donor organ. An infection developed in the postoperative course. Wimmer suffered a stroke from which he died on November 15, 1986 at the age of 55. After his cremation , the urn was transferred to Wimmer's hometown of Wörgl and buried in the family grave in the “New Cemetery” (urn wall, niche U24). Only a few months later, heart transplants at the Innsbruck University Hospital were discontinued due to limited capacity in the intensive care unit . Only in the late autumn of 1993 was the transplant department able to resume operations after renovations.

literature

• Karl Wendl: Heart recipient is back at home: “I'm just wonderful!” In: Kronen Zeitung of December 7, 1983 ( online ), p. 6.
• Raimund Margreiter : October 11, 1983 - the first HTX in Austria. In: Alive! Festschrift 25 years of the Austrian Association of Heart and Lung Transplants. November 2012, pp. 6-7. ( online )
• Mario Zenhäusern: Pioneers at the clinic: 30 years ago, on October 11, 1983. In: Tiroler Tageszeitung, October 11, 2013, p. 6. ( online )
• Raimund Margreiter: Transplantation in Austria - a historical review. In: Austrian Transplant Journal, issue 1/2017. ( online )

Web links

• First heart transplant in Austria in Innsbruck. Broadcast by ORF on September 29, 1993, accessed on January 27, 2018.
• 30 years of heart transplant. ORF.AT on October 11, 2013.

Individual evidence

1. ↑ ^{a b c d e} Karl Wendl: Heart recipient is back home: “I'm just wonderful!” In: Kronen Zeitung of December 7, 1983.
2. ↑ ^{a b c d e f g h i} Raimund Margreiter: Transplantation in Austria - a historical review. In: Austrian Transplant Journal, issue 1/2017.
3. ↑ ^{a b c d} First heart transplant in Austria: A second heart beats next to your own in your chest. In: Arbeiter-Zeitung of October 13, 1983, p. 5 ( online ), accessed on January 27, 2018.
4. ↑ front page Austria's first heart transplant was successful! Courier from October 12, 1983, shown in: Milestone in domestic medicine: Ernst Wolner on Austria's first successful heart transplant. ( online ( memento of the original from January 27, 2018 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this note. ), accessed on January 26, 2018. 
5. ↑ ^{a b c} Mario Zenhäusern: Pioneers at the clinic: 30 years ago, on October 11, 1983. In: Tiroler Tageszeitung of October 11, 2013, p. 6.
6. ↑ ^{a b c d} Austria's first heart transplant in Innsbruck. ORF, September 29, 1993.
7. ↑ 30 years of heart transplant. ORF, October 11, 2013.