Denise Darvall

Denise Ann Darvall (27 February 1942 – 3 December 1967) was the donor in the world’s first successful human heart transplant, performed at Groote Schuur Hospital, South Africa, by a team of surgeons led by Christiaan Barnard.

Darvall was seriously injured in a car accident on Main Road in Observatory, Cape Town. She and her family were visiting friends for afternoon tea and went shopping for cake. They were run over by a drunk driver who failed to see them. Her mother died immediately. Darvall sustained a skull fracture and severe head injuries, after the car flung her across the road and her head hit the wheel cap of her own car. She could not stay alive without life support, and was essentially brain dead. At 9 p.m. on the day of the accident, the resuscitation team stopped trying to revive her.

Edward Darvall arranged for his fourteen-year son, who had witnessed the accident, to be taken away from the hospital. 66-year-old Edward was also given a sedative, and he waited while doctors worked on his daughter. Coert Venter and Bertie Bosman were the two doctors who informed him that there was nothing further they could do for Denise. There was no chance of bringing back even a remote semblance of consciousness, but her heart continued to beat and pump blood inside an empty shell. Bosman explained that there was a man in the hospital they might be able to help, and asked Edward if he would consider allowing them to transplant Denise's heart. At this point Venter and Bosman withdrew, stating that Edward should take as much time as he needed and that they would understand if he declined to give his permission.

Edward Darvall later said that he thought only of his daughter in the four minutes it took him to reach his decision. He remembered a birthday cake she had made for him and a bathrobe she had purchased for him from her first paycheck at a new job. He began to cry, and in that moment knew what must be done. He called the doctors back and gave his permission.

Surgeons had a serious ethical problem because death then could only be declared by whole-body standards. The Harvard Criteria of Brain Death was not developed until 1968, nor was it adopted in South Africa or elsewhere for some years. The problem in this case was that, although Denise's brain was damaged, her heart was healthy. Various reports over the years attributed conflicting reasons for her heart stopping. For forty years, Barnard's brother Marius kept a secret: that rather than wait for her heart to stop beating, at Marius’s urging, Christiaan had injected potassium into Denise’s heart to paralyze it and thus, to render her technically dead by the whole-body standard.

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