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It was all about hearts and mines for Sir Terence




The man who pioneered the first successful heart transplant at Royal Papworth hospital 40 years ago could have been lost to a career as a mining engineer.

But, thanks to the generosity of Dr George Houston, Sir Terence English got a second chance to work in the field of medicine and went on to change the history of the world as well as the lives of patients.

Sir Terence performed the landmark transplant in 1979 and was the catalyst in forming the transplant unit at Royal Papworth Hospital. There had been previous heart transplant attempts in the UK in 1968 but these were not successful.

Royal Papworth Hospital NHS Foundation Trust celebrated the 40th anniversary of Keith Castle's transplant by inviting Sir Terence English to the new hospital. Picture: Keith Heppell
Royal Papworth Hospital NHS Foundation Trust celebrated the 40th anniversary of Keith Castle's transplant by inviting Sir Terence English to the new hospital. Picture: Keith Heppell

The retired cardiac surgeon returned to Papworth to celebrate the anniversary with Richard Worthington, one of the country’s longest-livingtransplant survivors, and Keith Castle Jr, son of Keith Castle, who survived for more than five years.

However, a moratorium was placed on further attempts even though the operation on Keith Castle was considered a success because he recovered well enough to not only go home, but also live for more than five years post-transplant.

Sir Terence said: “It’s very hard to say how long Keith’s survival would have been without the transplant, but we are talking about weeks or even days. He had peripheral vascular disease and was very sick. We’d waited a long time for a donor heart to become available for him.

From the left: Keith Castle Jnr, Sir Terence English, and Richard Worthington who is one of the longest-surviving heart transplant patients in the UK. Picture: Keith Heppell. (15662179)
From the left: Keith Castle Jnr, Sir Terence English, and Richard Worthington who is one of the longest-surviving heart transplant patients in the UK. Picture: Keith Heppell. (15662179)

“Before the operation, I’d been met with tremendous criticism about heart transplantation, including a letter from the Department for Health at the end of 1978 saying there would be no funding and the moratorium on heart transplantation would be continuing.

“I thought ‘damn that’ and managed to get approval from Pauline Burnet at the Cambridge Area Health Authority and we went ahead.

“Keith spent 28 days in isolation following the transplant and his success allowed us to generate more funding to ensure the heart transplant programme in the UK could become what it is today.”

But it could have been so different as Sir Terence won a scholarship to study mining engineering at Witwatersrand University in Johannesburg.

However, when he was 21, he unexpectedly inherited £2,000 and, with the encouragement of an uncle who was a surgeon, decided to become a doctor. The dean at Guy’s Medical School in London received his letter requesting to study medicine and offered him a place on the condition that he passed his engineering degree, which he did.

Terence English in surgery around 1980. Picture: Papworth Hospital Archive. (15662174)
Terence English in surgery around 1980. Picture: Papworth Hospital Archive. (15662174)

But the beginning of his second year of studies, he doubted whether he had made the right decision and moved to Canada to work as a mining engineer. In July that year, realising the mistake he had made, he asked the dean if he would readmit him – and he did.

Now 86, Sir Terence recalled: ‘I’ve thanked Dr Houston many times. We received honorary fellowships of Guy’s and St Thomas’ at the same time, which was a huge thrill for me. I wrote to him on his 96th birthday to thank him again. He died a few months later. I will never forget how he saved my career; he was a wonderful man.

Richard Worthington, one of the longest-surviving heart transplant patients, had his operation at Royal Papworth back in 1984.

His return to the hospital to meet up with Sir Terence and Keith Castle Jnr was just like a family get together as they celebrated the 40th anniversary of the first successful transplant.

Royal Papworth Hospital has now introduced its new name after receiving a royal title from Her Majesty The Queen in September last year.
Royal Papworth Hospital has now introduced its new name after receiving a royal title from Her Majesty The Queen in September last year.

Richard admitted: “I didn’t expect there would be this much interest in the anniversary. When I first found out I needed a transplant, I was too ill to know really. I was only 20. It was the only option I had. I caught viral cardiomyopathy and my health went downhill very quick.

“I caught the bug in December 1983 but the doctor heard a faint crackle and sent me for an X-ray, that’s when they found I had an enlarged heart. They tried to intervene with drug therapy but they told me in 1984 that my only chance would be a transplant. It was difficult to take at that stage. I was told that I had got maybe 10 years to live, my parents were told I’d actually got five years to live, so it was very difficult.

“It was just a bug that started it off I was totally fit before then. They transferred me to St George’s in Tooting and then to Papworth and had my transplant within a couple of days.”

But Mr Worthington is under no illusions about the impact both Professor John Wallwork and Sir Terence have had on his life.

“I’ve lived life to the full as a result,” he said. “I take my hat off to all the surgeons’ skills, their knowledge, and also to everybody who was around me who got me back to normal life.

“I do quite a bit of lifting and that keeps me physically fit but nothing has held me back. I am eternally grateful to Sir Terence and John Wallwork, without them I would not be here.

“Their work has allowed me to live my life; get married, have children and see them grow up. Sir Terence is very switched on and a very respected gentleman. I’ve been very lucky and long may it continue.”

HEART TRANSPLANT TIMELINE

1967 The world’s first heart transplant was performed 12 years previously, by Christiaan Barnard at Grote Schur Hospital in Cape Town, South Africa, in 1967.

1968 The first in the UK – and 10th in the world – took place in 1968 at the National Heart Hospital in London with a couple more to follow by 1969.

1969 Survival rates fail to improve and a moratorium is placed on heart transplantation in the UK.

1979 Royal Papworth performs its first heart transplant in January 1979, but the patient died just over two weeks later in hospital. Sir Terence performs Keith Castle’s operation on August 18. Keith comes round and regains consciousness the following day.

January 1980 Keith is discharged from hospital and as a result becomes the first UK heart transplant recipient to be discharged from hospital, thus making it the first successful UK heart transplant. Keith lives for more than five years post-transplant.

1984 Europe’s first successful heart-lung transplant performed at Royal Papworth

1986 World’s first successful heart-lung and liver transplant performed at Royal Papworth

2015 Europe’s first non-beating (DCD) heart transplant performed at Royal Papworth.



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