Historical Note

Abstract

Tymoteusz Borys Budny and Hans-Ullrich Spiegel Surgical Research, Department of General Surgery, University Hospital Muenster, Muenster, Germany Hans Jürgen Bretschneider (1922–1993), son of a general practitioner, was born in Neubrandenburg on July 30, 1922. At the university he first attended two semesters of ship building. After the war, in 1946, he started to study medicine and mathematics at the University of Goettingen where he successfully finished his studies in mathematics in 1950 and medicine in 1952. In 1960, after his residency, Bretschneider acquired the specialty in internal medicine. In addition, he qualified as a professor in the field of pathological physiology with the subject of “mechanism of the hypoxic coronary dilatation.” In his dissertation as well as in his postdoctoral thesis, two important characteristics appeared in his work—meticulous methodology and, above all, relevant clinically related research. On May 1, 1960, H. J. Bretschneider accepted the offer made by Prof. Dr. Georg Heberer, former chief of the surgical department at the University Hospital of Cologne, to set up the first department for experimental surgery in Germany. They both recognized that high-level research was possible only on an “interdisciplinary level.” At that time, they established a research group consisting of surgeons and physiologists. This turned out to be very successful in spite of little monetary means, which was very different at that time in America where research was pushed ahead with significant financial support. H. J. Bretschneider then devoted himself to the question of myocardial energetics under anaerobiosis. At that time, he postulated that the ischemia tolerance of the heart was dependant on energy demand. Shortly after, H. J. Bretschneider proved his theory by demonstrating that a heart suffering from a cardiac arrest at low heart rate, induced e.g. by anaesthesia, showed a higher ischemia tolerance [1]. At that time, this knowledge was of special importance for the “new-heart–lung machine,” which was first used in open heart surgery in 1961 in Merheim, Cologne. Thereupon, in 1964, on the drawing board, H. J. Bretschneider developed a cardioplegia solution reducing the extracellular sodium and calcium level to nearly cytosolic values. After Bretschneider accepted the chair of vegetative physiology and pathophysiology at the University of Goettingen in 1968, it was there where he optimized the cardioplegia solution by artificial buffering using the amino acid buffer histidine/histidine–HCl. Furthermore, he realized that the ischemia tolerance is also depending on the evacuation and/or the interception of the metabolites in the hypoxic time. This solution allows an unproblematic resuscitation of the heart even after 5 hours of ischemia. By 1980 this solution started to find its way into clinical heart transplantation under the name of Address correspondence to Dr. Hans-Ullrich Spiegel, Surgical Research, Department of General Surgery, University Hospital Muenster, Muenster, 48149, Germany.