University of Mississippi Medical Center (UMMC): Original Hospital Operating Room #10

Operating room #10 is the operating room where the first successful human lung transplant, performed by Dr. James D. Hardy, took place. It is located in the University of Mississippi Medical Center (UMMC) in Jackson, MS. The operation was performed from the night of June 11 to the morning of June 12, 1963. The recipient, a man named John Russell who was suffering from an almost completely destroyed lung as well as renal failure, lived for 18 days after the operation, with evidence to support that it wasn't the transplant itself that killed him, but the various complications that led to the transplant. Russell's right lung had been weakened by advanced emphysema. It is notable, from an ethico-legal perspective, that the patient was also a prisoner. He was, of course, offered the choice, and was not told that he would gain anything as far as his sentence--a life sentence--went. However, according to Hardy, the state did indicate to him privately that it would be taken into consideration if Russell would "contribute to human progress in some way". In fact, Ross Barnett, the then governor of Mississippi, commuted Russell's sentence as a reward for his agreement to "alleviate human misery and suffering in years to come" (Fedson, 2016). Operating Room #10 is in a part of the original hospital that is not open to the public.

The first successful lung transplantation took place in this room. Lung transplantation had, of course, been attempted before. The first attempts at lung transplantation took place in Russia in the 1940s by a surgeon named Vladimir P. Demikhov, more well-known for successfully transplanting an extra head onto a dog (Langer, 2011). He also made the first signs of headway on lung transplantation by experimenting on dogs. There were 67 attempts made, but only six dogs lived past the 48 hour mark, and only two dogs lived past four days. During the span of their post-surgery survival, however, some of them seemed quite healthy, able to "walk, drink, and eat". It was in 1950 in Marseille, France, that a man by the name of Henri Metras performed a successful lung transplantation on a dog (Raemdonck, Venuta, 2017).

Thirteen years later, a 58 year old prisoner from the Mississippi State Penitentiary, John Russell, "was admitted to University Hospital with a history of repeated bouts of pneumonia that antibiotics had failed to improve. Squamous cell carcinoma in his left lung had rendered it all but useless, and his right lung had been weakened by advanced emphysema. Russell also suffered from kidney disease" (Find It in Fondren, 2013). It is notable, from an ethico-legal perspective, that the patient was also a prisoner. He was, of course, offered the choice, and was not told that he would gain anything as far as his sentence--a life sentence--went. However, according to Hardy, the state did indicate to him privately that it would be taken into consideration if Russell would "contribute to human progress in some way". In fact, Ross Barnett, the then governor of Mississippi, commuted Russell's sentence as a reward for his agreement to "alleviate human misery and suffering in years to come" (Fedson, 2016). It had previously been agreed upon that any experimental recipient must be dealing with some unrelated disease that could be fatal, such as a tumor, as well as one lung that was virtually already destroyed, to justify the procedure. John Russell fit this criteria. He agreed to the experimental surgery, which began on the evening of June 11th, and ended on June 12th. Though there were complications (for example, the donor lung appearing to be too big when they first began surgery), three hours later, Russell had a new lung. Upon waking from the surgery, he was able to breathe more easily than he had been in a long time, as before the surgery, he would wake in the night coughing up blood until he thought he would suffocate. He reportedly was informed he had a new lung, smiled, and then went back to sleep (Festle, 2012).

The patient lived for 18 more days before dying of increasingly severe renal failure that had already been present before the operation, making it the first successful human lung transplant (Raemdonck, Venuta, 2017). Incredibly, this transplant was not the only world-changing event to happen in UMMC that very night; as the transplantation was being performed, Medgar Evers, civil rights activist and leader of the NAACP chapter in Mississippi, was dying due to an assassin's gunshot just one room away, which the exhausted surgeons learned when coming to the front desk of the hospital after emerging from the operating room. The lung transplant made the front page of the Jackson-Clarion Ledger, in a small, bottom-corner article (Festle, 2012). Despite the lack of wide-spread coverage on the first successful lung transplantation, it still had big implications for the human race by proving that lung transplants were possible.

This huge step in the science organ transplantation was performed by Dr. James D. Hardy. Hardy was born in 1918 in Newala, Alabama. He began his studies at the University of Alabama in 1938, but transferred to the University of Pennsylvania to complete them, as Alabama only offered a two-year medical program at the time. He received his M.D. in 1942. Two years later, he was called upon by the United States Army to serve as an army doctor, which he did in Europe for two years. It was here that he decided he wanted to become a surgeon, which he did upon returning to the United States. He found himself in Mississippi in 1955, when the University of Mississippi Medical Center (UMMC) opened in Jackson, MS, and he was made the first chair of the Department of Surgery, a position he held until 1987. His interest in human lung transplantation was made known in 1962, when he announced his intentions to perform one at a surgical conference, before consulting with Robert Marston, the dean of UMMC at the time. He believed that in emergency circumstances, experimental human lung transplantation was justified to prolong a person's life. The story of John Russell told above was the event that realized that ambition of his, and justified his conviction that human lung transplantation was not only possible, but could potentially benefit the human race. This was not his only contribution to what we know now of surgery; the year after his first successful lung transplantation, he took the medical world by storm with the first successful animal-to-human heart transplantation (Festle, 2012). James D. Hardy died in 2003 in Jackson, Mississippi (Prono, 2021).

Hardy is also responsible for the first animal-to-human heart transplant performed one year after the lung transplant, in which he took a chimpanzee heart and transplanted it into a man, a surgery which garnered more criticism than the lung transplant a year prior. Despite criticism and controversy surrounding some of his experiments and surgeries, it is indisputable that he helped to put Mississippi, a state known for often being behind the rest of the country, on the map in terms of medical history and advancements.

Eraslan, Sadan. Hardy, James D. Webb, Watts R. Transplantation of the Lung. Department of Surgery and University Hospital. vol. 160, no. 3. September, 1964.

Fedson, David S. "Treating the host response to emerging virus diseases: Lessons learned from sepsis, pneumonia, influenza, and Ebola. Annals of Translational Medicine 4 (2016): 421.

Festle, M. Second Wind: Oral Histories of Lung Transplant Survivors. Published February 14, 2012.

Find It in Fondren . UMMC Marks 50th Anniv. of World's First Lung Transplant, Find It in Fondren . June 11th 2013. Accessed April 9th 2021. https://www.finditinfondren.com/2013/06/10/ummc-marks-50th-anniv-worlds-lung-transplant/.

Hardy, James D. The First Lung Transplant in Man (1963) and the First Heart Transplant in Man (1964). Elsevier . Published 1999.

Langer, R.M. Vladimir P. Demikhov, A Pioneer of Organ Transplantation. National Library of Medicine. May 2011. Accessed April 2021.

Prono, Luca. James D. Hardy, Britannica . February 15th 2021. Accessed April 9th 2021. https://www.britannica.com/biography/James-D-Hardy.

Raemdonck, Dirk Van. Venuta , Federico . History of Lung Transplantation . Journal of Thoracic Disease. Published December 9th 2017.