It was a similarly startling sensation like the first landing on the moon when Dr. Christiaan Barnard successfully carried out the first transplant on his 55-year-old patient Louis Washkansky during a five hour operation in December 1967 in the "Groote-Schur"-hospital in Cape Town. And although Barnard himself, who often gladly visits Vienna and his Heurigen, always played down his achievement at that time ("The heart is just a pump!"), he and the highly modern "Groote-Schur"-hospital in South Africa achieved world fame over night.
For 14 years now Dr. Peter Zilla has been the Austrian successor to the great Bernard, who died in 2001 at the age of 78 in the hospital on the Cape of Good Hope, in a "Clinic surrounded by palm trees", which continues to search for his peers. Not only are tiny so-called routine "stents" carried out with fine wire networks in the blocked arteries of smokers, so that the "blood flow" to the heart is once again clear, but heart valves are also transplanted, so that the "pumps" once again transport enough blood. Cutting-edge research is also carried out under the leadership of the Austrian.
Prof. Dr. Zilla on a visit in Capetown: "Even when heart and bypass operations have become routine throughout the world, the problem still remains that the implants that we receive from organ donors and the prostheses made from titanium, plastic or pig tissue do not last forever. After problems during a routine heart operation in 1997, US-Governor Arnold Schwarzenegger, for example, now has two implanted heart valves, which will probably have to be replaced at some point in the next few years. A repeated and difficult intervention that would rather be avoided."
In the heart research department of "Groote-Schur" in Cape Town, doctors, biologists, chemists and engineers are all working on multidisciplinary solutions for this problem, under the leadership of Dr. Zilla. Four sinfully expensive thermionic microscopes are at the scientists’ disposition, as well as a fully automatic "ultra-microtome" by the Viennese company Reichert, with which tissue around one millionth of a millimetre in size can be cut and examine. One of the ambitious aims of the scientists is, for example, to improve the currently used "stents", with which constricted veins are held open, in such a way that after the operation they convert with time into bodily tissue.
Dr. Zilla: "Nowadays we can create artificial gels that are practically invisible to the body and are not seen as foreign bodies and thus rejected without the use of appropriate medications, as was the case with the pig heart valves that were often used in operations. The idea now is that the body’s own tissue should in predetermined places grow into the tiny cavities of such an artificial prosthesis. Through the integration of special ‘bio-keys’ made from peptides, it is possible to make a specific type of cell dock and becomes active, and to ensure that others that may be unwanted don’t. This method "puzzle-piece" method will be a deciding factor in the regeneration of organs in 20 to 30 years. Here in Cape Town, we have demonstrated through experiments that this regeneration already works with arteries, but it will be another 3 to 4 years before we try it out in the clinic."
Precursor in the area of "Tissue Engineering", as it is called in technical jargon, was incidentally Peter Zilla’s former boss Prof. Manfred Deutsch, who until recently was the director of surgery in Vienna’s Lainz hospital. Dr. Zilla: "22 years ago in Lainz we had already propagated venous cells of a patient in labour and made them grow using a few little tricks on the inside of a small plastic capillary tube, that was then implanted in the patient’s leg as a replacement for a constricted artery. The body can get to grips with this much better and the new "artery" has not closed up five years on. With this method, which has been successfully practiced there for over 10 years, has secured Lainz a place on the world map in medical terms."
The fact that ground-breaking discoveries in medicine often require centuries before becoming routine worldwide is one of the few things that bothers Dr. Peter Zilla, who comes skiing in Austria with his wife every year, in his life-saving dream job: "And also the fact that most scientists are so in love with there specialist field, that they do not work together with others in a multidisciplinary way." What annoys him even more is how difficult it is in South Africa to get good salami. "And that there are no Heurigen here..."