The South African surgeon Christiaan Barnard, who has died aged 78, led the surgical team that performed the first human-to-human heart transplant on December 2-3 1967. The operation captured public imagination around the globe, and, literally overnight, Barnard became one of the best known people in the world.
Although his achievement, courage and vision should not be underestimated, the transplant was, as Barnard readily admitted, just one more step in the progress of surgery. Unlike many other pioneering surgeons, however, he had charisma - a blend of good looks, intelligence, wit, an often naive honesty and the unashamed expression of emotion - that made others want to see him, talk to him, and be with him.
Born in the small country town of Beaufort West, in the Western Cape, Barnard was one of four sons of a pastor who ministered to the local mixed race, or "coloured" congregation. The family was poor but, having done well at school, he went on to the University of Cape Town medical school. He was not an outstanding student, but worked hard and graduated in 1946. He soon married, and, after short periods as a country GP, began training in surgery at Groote Schuur hospital, Cape Town, where, working largely at night, he carried out research on the cause of bowel obstruction in infants.
In 1956, he went for two years to Minneapolis, a centre of open-heart surgery, where he learnt new surgical techniques and did research on heart-lung machines.
Returning to Cape Town in 1958 as a specialist in cardiothoracic surgery and director of surgical research, Barnard organised one of the first open-heart surgery programmes in Africa, working at both Groote Schuur and the nearby Red Cross children's hospital. Operating was clearly stressful for him - he was, by no means, a natural surgeon - and there were episodes of vitriolic abuse of those assisting him. Despite this, he engendered great personal loyalty.
With Carl Goosen, he designed a successful, new heart valve prosthesis, and introduced intensive care, which, although commonplace today, was virtually unknown before the introduction of heart surgery. His untiring attention to his patients was legendary.
By the mid-1960s, Barnard was giving active thought to the possibility of heart transplantation. With his brother Marius, also a cardiac surgeon, he perfected the operation on dogs, and later spent three months at Virginia medical college getting experience of immunosuppressive drug regimes in patients undergoing kidney transplantation.
Although Louis Washkansky, the first heart transplant patient, survived for only 18 days, the second, Philip Blaiberg, lived an active life for 19 months. Four of Barnard's first 10 patients lived for more than a year, two surviving longer than 10 years, with one surviving into his 24th year.
The programme's early success gave Barnard the opportunity to act as an unofficial ambassador for his then troubled homeland. He opposed apartheid, but defended other controversial government actions. An outstanding public speaker, he could pitch his presentation exactly to his audience, whether of eminent doctors or schoolchildren, and he was equally at ease in media interviews. Following the success of his autobiog- raphy, One Life (1970), he collaborated with a South African novelist on several books of fiction, and wrote several others on health for the general public. For many years, he contributed a weekly column to the Cape Times and its sister news- papers in South Africa.
His lifestyle evolved; his suits were made by an Italian tailor, and he grew his hair trendily long. His penchant for being in the company of beautiful women made him a favourite of the paparazzi. His first marriage, which had given him a daughter and a son, broke up, and he married Barbara Zoellner, a beautiful and wealthy 19-year-old, with whom he had two sons.
Barnard was made professor of surgical science at Groote Schuur in 1972, though it always irked him that he was never given the title of professor of cardiac surgery. Two years later, with Jacques Losman, he developed the technique of auxiliary heart transplantation - the so-called piggyback heart transplant, where the donor heart was placed in the chest alongside the patient's own heart.
But during the early 1980s, two traumatic events took an emotional toll on his life. His oldest son, himself a young Cape Town doctor, died, and his second marriage broke up. With rheumatoid arthritis affecting his hands, he retired in 1983, at the age of 61.
Barnard's high profile enabled him to participate in several business interests, including Cape Town restaurants and a cattle farm. Later, he was involved in the transformation of a large sheep farm in the Karoo into a game reserve. He also developed a profitable advisory role with the Swiss Clinique La Prairie, whose main interest was in the controversial field of rejuvenation by injection of extracts from the foetuses of sheep. His involvement in the advertising campaign of Glycel, a cream purported to help prevent ageing of the skin, further tarnished his image.
In 1987, after two years as scientist-in-residence at the Oklahoma Transplantation Institute, Barnard returned to South Africa and, at the age of 65, married a fashion model 40 years his junior, with whom he had two more children. He fell steadily out of the limelight, except in South Africa, where he and his family retained something of the Kennedy aura about them.
•Christiaan Neethling Barnard, surgeon, born November 8 1922; died August 2 2001
