James D. Hardy (May 14, 1918 – February 19, 2003) was an American surgeon who performed the world's first lung transplant into John Russell, who lived 18 days. The transplant was performed at the University of Mississippi Medical Center in Jackson, Mississippi on June 11, 1963. Hardy also attempted the world's first modern heart transplant when he transplanted the heart of a chimpanzee into comatose and dying Boyd Rush's chest during the early morning of January 24, 1964. This heart beat for approximately one hour, and then Rush died without regaining consciousness. The consent form did not disclose that a chimpanzee heart might be used, although Hardy stated that he had discussed this with Rush's stepsister. Before the transplant attempt, Hardy asked the four doctors who would be assisting him, to vote whether to proceed. One said yes, one abstained, and the last two nodded yes. This operation was also performed at the University of Mississippi Medical Center in Jackson. It was the world's first modern heart xenotransplant since Hardy used a chimp's heart.
Early life James Hardy grew up in Newala, Alabama, a small community in Shelby County. His father owned a lime plant in Newala. He studied at a high school in Montevallo before entering the University of Alabama for pre-medical curriculum. He received his MD in 1942 from University of Pennsylvania School of Medicine in Philadelphia. He held the office of the president of Alpha Omega Alpha during his senior year and his first scientific publication was on wound healings.
Career Hardy served in the U.S. Army Medical Corps in early 1944 during the Second World War. He first worked at Stark General Hospital, Charleston in South Carolina. Hardy began writing his first book, Surgery and the Endocrine System, in 1950 which was published two years later. He was awarded the Master of Medical Science in physiological chemistry by the University of Pennsylvania in 1951 for his research on using heavy water for measuring body fluids. He became the chair of surgery at the University of Mississippi School of Medicine, Jackson in 1955. He was also the first Professor of Surgery at the University of Mississippi School of Medicine. Hardy wrote 24 books, 139 book chapters, 466 papers, and produced over 200 films. Vishnevsky Institute, Moscow honored him in 1971 for his pioneering work in organ transplantation and awarded him two medals for lung transplant and heart, respectively. He has served as President of the Society of University Surgeons, the Society of Surgical Chairmen, the Southern Surgical Association, the American College of Surgeons, the American Surgical Association and the International Society of Surgery. Hardy also led the team responsible for performing a double-lung transplant that left the heart in place, in 1987.
First lung transplant (1963) In April 1963, 58-year-old John Russell was admitted to the University of Mississippi Medical Center in Jackson, Mississippi, with recurrent pneumonia unresponsive to antibiotics. He also had emphysema of both lungs, squamous cell carcinoma of his left lung, and kidney disease. To complicate matters, Russell was a prisoner at the Mississippi State Penitentiary serving a life sentence for murder. One source states Russell was in prison for accidentally shooting and killing a 14-year-old boy. James Hardy wrote regarding this case, "Although the patient was serving a life sentence for a capital offense, there was no discussion with him regarding the possibility of a change in his prison sentence. However, authorities of the state government were contacted privately, and they indicated that a very favorable attitude might be adopted if the patient were to contribute to human progress in this way." Prior to the surgery, Russell would awake at night coughing up bloody sputum until he was blue in the face. Every movement left him extremely short of breath, and he was scared of suffocating. Tests showed he only had one-third of normal lung capacity. When Hardy approached him about the potential transplant, Russell talked with his wife and three children. His main concern was whether the transplant would help improve his shortness of breath. Hardy told him that he thought it would. Thoracic resident Martin Dalton sought and received permission from the family of a recently deceased heart attack patient to use their left lung. He used an endotracheal tube to keep the lungs ventilated and injected heparin into the heart to prevent clotting. When the time came, he removed the left lung and carried it to the adjacent operating room. On June 11, 1963, when Hardy and his team opened Russell's chest to begin the transplant, they saw that his cancer had spread beyond the left lung. The transplant would not save his life, but it might give him better breathing. The team continued with the planned transplant. The cancerous left lung had shrunk, and so had space around it. The team made space for the new lung and changed a few of the planned vascular connections. Watts Webb assisted Hardy with the transplant. Initially, the transplanted lung did provide Russell with better breathing, before kidney disease impacted him. Hardy used azathioprine, prednisone, and radiation to suppress his immune system. John Russell lived for another 18 days and then died of kidney failure. One source states that Russell died from a combination of cancer, infection, and kidney disease. The book Second Wind: Oral Histories of Lung Transplant Survivors (2012) states that University of Mississippi Medical Center had unreliable blood banking, no intensive care unit, only limited 24-hour lab support, a weak anesthesia program, and most critically for Russell, no artificial kidney machine. There is brief surviving film footage of the lung transplant. Martin McMullan participated in the operation as a surgical technician, and later became a doctor and a professor of surgery.
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