The first Italian heart transplantation: The history of the pioneers' experience

While Christiaan Barnard (1922 to 2001) was performing his first successful heart transplantation in Cape Town, South Africa, in 1967, a young Italian doctor, Vincenzo Gallucci (1935 to 1991), had just finished his specialty in general surgery at the University of Padua. After many experiences abroad, he became professor of general pathology and surgery, and director of the Cardiovascular Surgery Institute in 1983, then director of the Department of Transplant at Padua in 1991.After the clamor raised by Barnard, cardiac transplantations continued to fail during the 1970s because of the high mortality due to rejection. The discovery of cyclosporine changed the scenario completely. With this newly identified molecule and the introduction of endomyocardial biopsy for rejection monitoring, the heart transplant finally became a reality by the early 1980s. As soon as these conditions were met, Gallucci sent his collaborators to Stanford to learn the immunologic and surgical aspects of heart transplantation, and also to the course, held by Margareth Billingham (1930 to 2009), for training pathologists in endomyocardial biopsy in heart transplant patients. Billingham developed a standardized scale for interpreting such biopsy results that is still used in modified form—the Billingham Scheme, also known as Billingham’s criteria. Thanks to this training program, Gallucci performed the first heart transplant in Padua, Italy, on November 14, 1985, and thus acquired the nickname of the “Italian Barnard.”