UNC MEDICAL BULLETIN
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1983, during Egan’s first year in Cooper’s lab, Cooper and fellow in heart and heart-lung transplantation, performed the first successful isolated lung transplant. training under the tutelage of Dr. Norman Shumway, the “There was kind of a rivalry, between the Stanford pioneering surgeon who performed the first successful group and the Toronto group, about whether you heart transplant in the US in early 1968. needed to do heart and lung versus isolated lungs, and Like Starzl, Shumway is considered a giant in the Cooper proved that lungs could be done by themselves,” field of organ transplantation. Although South African said Egan, now UNC’s associate division chief for General doctor Christiaan Barnard had performed the world’s Thoracic Surgery. Egan and Cooper worked together first heart transplant in Cape Town one month before on techniques to perform bilateral lung transplants, Shumway did his first at Stanford, Barnard did so using and Cooper and his group performed the world’s first techniques that Shumway and his first chief resident, Dr. successful double-lung transplant in Toronto in 1986. Richard Lower, had developed over the previous decade. When Cooper left the University of Toronto in And Shumway was one who refused to give up on the 1988 to start a lung transplant program at Washington procedure when persistent organ rejection led most University in St. Louis, Missouri, he brought Egan along others to abandon it for much of the 1970s. with him. But it wasn’t long before Wilcox called, Now at UNC, Mill couldn’t keep the young heart-lung offering Egan a chance to start up a lung program of his transplant program he had inherited going all by himself, own, in conjunction with Mill’s heart program, at UNC. even though he performed his first transplant at UNC “It made for a very productive relationship, because within a month of his arrival. Transplant operations are he was the head of the lung transplant program and I extremely labor- and resource-intensive and require an was the head of the heart transplant program,” Mill said. enormous team effort to accomplish efficiently and with “So if he was doing a lung transplant, I could go get the best chance for success. In addition to the surgeons, the lung for him. If I was doing a transplant, he’d get nurses, and surgical technicians, transplant requires the heart for me. If one of us was out of town, the other anesthesiologists, transplant coordinators, cardiologists, could do the operation.” pulmonologists, pathologists and many others whose expertise must be brought into the fold. “It is a huge Transplant at UNC today institutional commitment,” says Mill. In 2009, 20 years after the establishment of UNC’s heart For one year, while Wilcox worked on recruiting and lung transplant programs, the face of transplant another surgeon, Mill forged on and drew together, from surgery at UNC, as well as around the world, has all corners of UNC Health Care, the multidisciplinary team the program needed. In July 1989, Dr. Tom Egan, a young surgeon with both heart and lung transplant experience, was hired to join Mill at UNC. Egan graduated from medical school in his home city at the University of Toronto in 1976 and, after three years as a medical officer and flight surgeon at the Canadian Forces base in Chatham, New Brunswick, returned to the University of Toronto. There, he spent the next eight years training in general, thoracic, and cardiovascular surgery, including two years as a resident and research fellow in the Division of Thoracic Surgery. It was there that Egan met Dr. Joel Cooper and began working in his lab. At the time, lung transplant was only being done as a heart and lung block— both lungs and the heart together— Dr. Michael Mill (left) with Dr. Norman Shumway in 1990. Shumway was visiting UNC making it an unwieldy and inefficient at Mill’s invitation to speak about his groundbreaking work in heart transplant surgery. procedure. However, in early November Photo courtesy of Dr. Michael Mill