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{{Short description|Indian vascular and cardiothoracic surgeon (1915–1982)}}
{{Use dmy dates|date=June 2018}}
{{Infobox medical person
| name = Prafulla Kumar Sen
| honorific_suffix =
| image = Prafulla Kumar Sen.jpg
| image_size =
| alt =
| caption =
| birth_name = 
| birth_date = 7 December 1915
| birth_place = [[Calcutta]], [[British India]]
| death_date = 22 July 1982
| death_place = [[Calcutta]], [[India]]
| death_cause =
| citizenship =
| education = [[University of Mumbai|University of Bombay]]
| occupation = [[Cardiothoracic surgeon]]
| years_active =
| known_for = Conducting the first human [[Heart transplantation|heart transplant]] in India (1968)
| relations = Marie Barnes
| website =
| profession =
| field =
| work_institutions = [[King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College]]
| specialism = [[Transplant surgery]]
| research_field =
| notable_works =
| prizes = [[Padma Bhushan]]
| child =
| module2 =
| signature =
}}
'''Prafulla Kumar Sen''' [[Doctor of Medicine|MD]] (7 December 1915 – 22 July 1982) was an Indian [[Blood vessel|vascular]] and [[cardiothoracic surgeon]], who led the world's sixth attempt of human [[Heart transplantation|heart transplant]] and India's first in 1968. It dubbed him the fourth surgeon in the world to carry out this operation.

Sen was active in establishing postgraduate programmes in surgical training and one of the early surgeons to perform [[aortic]] surgery in India in the 1950s. After being the first in India to perform a [[Mitral valve stenosis#Mitral valvuloplasty|closed mitral valvotomy]] in 1952, within a year he repaired a [[coarctation of the aorta]] and by 1956 he had successfully attempted the first direct vision closure of an [[atrial septal defect]]. In the 1950s he turned his attention from aortic surgery to open heart surgery following numerous experiments on dogs. He subsequently led teams that performed two heart transplants in [[Mumbai|Bombay]] in 1968. Both recipients died on the day of their operation.

Sen was, in addition, a poet and painter. His paintings were displayed once in the United States, and twice in India.

==Early life and education==
Prafulla Kumar Sen, popularly known as P. K. Sen,<ref name=Hosain1970>{{cite journal |last1=Hosain |first1=Nazmul |title=Dr. P K Sen- the Bengali Surgeon of the Century |journal=Cardiovascular Journal |date=1 January 1970 |url=https://www.academia.edu/81449150|volume=3|issue=2|pages=254–257 |doi=10.3329/cardio.v3i2.9200 |doi-access=free }}</ref> was born on 7 December 1915 in [[Kolkata|Calcutta]], [[Presidencies and provinces of British India|British India]].<ref name=":Obituary1982">{{Cite journal|date=1 October 1982|title=Professor Prafulla Kumar Sen 1915~1982|journal=Indian Journal of Thoracic and Cardiovascular Surgery|language=en|volume=1|issue=1|pages=92–94|doi=10.1007/BF02664159|issn=0970-9134}}{{Subscription required}}
</ref> He had one sister and his father was a civil servant.<ref name=":Mittal2002">{{Cite journal|last=Mittal|first=Chander Mohan|date=2002|title=Profulla Kumar Sen|pmc=101263|journal=Texas Heart Institute Journal|volume=29|issue=1|pages=17–25|issn=0730-2347|pmid=11995843}}</ref>

He began his early education at a public school in Jamtada, [[Bihar]],<ref name=":Mittal2002"/> before attending the Victoria College of Sciences, [[Nagpur]]. Subsequently, Sen gained admission to medicine at the [[King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College|G.S. Medical College]], Bombay, where he studied between 1933 and 1938, before passing his [[MBBS]]. In 1940, he achieved a distinction in his [[Master of Surgery|master of surgery]] (MS) degree at the [[University of Mumbai|University of Bombay]].<ref name=":Obituary1982"/>

==Surgical career==
Sen's internships and surgical training were completed at [[King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College|King Edward VII Memorial Hospital]] (KEM), Bombay between 1938 and 1943, after which he returned to G.S. Medical College as assistant honorary surgeon.<ref name=":Mittal2002" /> Initially, he received aid from the [[Indian Council for Medical Research]] (ICMR). He was frequently in dispute with the Bombay Municipal Corporation who were more concerned with providing for diseases of poverty and over population. However, he was ambitious, a "buccaneer" and had a wish to extend Indian medicine into the rapidly growing and exciting arena of open heart surgery.<ref name="Jones2018" /> He was inspired by [[Charaka]] but also paid tribute to Western medical pioneers including [[John Hunter (surgeon)|John Hunter]] and [[Alexis Carrel]].<ref name="Jones2018" />

===Pennsylvania===
In 1949, following an application for a [[Rockefeller Foundation]] fellowship and the subsequent endorsement by Isidor Schwaner Ravdin, chair of surgery at the [[University of Pennsylvania]] at their request, Sen travelled to the University of Pennsylvania in the United States to work for six months with thoracic surgeon [[James Hardy (surgeon)|James Hardy]]. Their research on the "impact of surgery on adrenocortical activity" was presented at the [[American College of Surgeons]] in [[Boston]] in October 1950 and later, amidst the backdrop of racial unrest in the U.S. and an incident in which Sen was nearly barred from a hotel, at the [[American Physiological Society]] in Atlanta. Before returning to India in 1952, Sen visited surgical research centres all over the United States including Minneapolis, New York and Baltimore. In addition, he visited London and Sweden. Over the next fifteen years, he obtained another two travel fellowships to the U.S., with assistance from the Rockefeller foundation.<ref name="Jones2018"/>

===Return to India===
In 1952, he was appointed to KEM Hospital as honorary surgeon, but soon left to take up the post of director professor of surgery at G.S. Medical College, the post he held until his retirement in 1973.<ref name=":Mittal2002"/>

He initially worked in experimental and clinical research, but was later active in establishing postgraduate qualifications in cardiothoracic surgery during a period in which he also founded specialist departments at G.S. Medical college and the KEM Hospital, including gastrointestinal and hepatic surgery, sports medicine and oncology.<ref name=":Obituary1982"/>

===Early cardiovascular surgery===
In addition to North American networks, Rockefeller support and funding, and the ICMR,<ref name="Jones2018" /> Sen was also influenced by Soviet surgeons, particularly [[Vladimir Demikhov]]. Along with other KEM Hospital cardiothoracic surgeons including M. D. Kelkar, [[G. B. Parulkar]] who established the technique of hypothermic circulatory arrest in resection of aortic aneurysm and T. P.Kulkarni who described tuberculous aortitis, Sen was one of the first to perform aortic surgery in the 1950s, laying the foundations at first for aortic surgery and then later open heart surgery in India.<ref name="Dardik2016">{{cite book|last1=Unnikrishan|first1=Madathipat|title=Vascular Surgery: A Global Perspective|last2=Savlania|first2=Ajay|last3=Goura|first3=Prakash|last4=Tripathi|first4=Ramesh K.|publisher=Springer|year=2016|isbn=978-3-319-33743-2|editor=Alan Dardik|location=|page=64|chapter=Aortic Disease and Management in India|doi=10.1007/978-3-319-33745-6|lccn=2016948201|chapter-url=https://books.google.com/books?id=de9NDQAAQBAJ&pg=PA64}}</ref>

In 1952, following the adaptation of American techniques and after 25 dog experiments, he successfully performed the first intra-cardiac procedure in India by pushing his finger through a [[rheumatic heart disease|rheumatic]] [[mitral valve]] (closed mitral valvotomy) via a cut made in the [[right atrium]] of a beating heart.<ref name=":Obituary1982"/><ref name="Jones2018" /> In 1953, he repaired a [[coarctation]] of the aorta and by 1956 he had successfully attempted the first direct vision closure of an atrial septal defect under [[hypothermia]] and inflow occlusion.<ref name="ChopraNanda2013">{{cite book|last=Iyer|first=K. S.|editor=H. K. Chopra|others=Navin C. Nanda|title=Textbook of Cardiology: A Clinical and Historical Perspective|chapter-url=https://books.google.com/books?id=3UPHBAAAQBAJ&pg=PA713|year=2013|publisher=Jaypee Brothers Medical Publishers Pvt. Ltd.|isbn=978-93-5090-081-9|page=713|chapter=84. The History of Congenital Heart Surgery}}</ref> Around the same time, he initiated other vascular repair procedures on the [[Aorta]] for the surgical treatment of [[Aortitis]] and [[Aortic aneurysms]].<ref name=":Obituary1982"/>

By 1957, Sen had completed his second travel fellowship and tour of major North American and European cardiac centres. In addition, on his return to India, he hosted foreign delegates, one of whom was [[William Heneage Ogilvie]] (of [[Ogilvie syndrome]]), in early 1958.<ref name="Jones2018" />

He was at first skeptical of [[heart-lung machines]] and concentrated chiefly on hypothermia in his transplant surgery, but by the early 1960s he had secured Rockefeller funding to train a group of Indian surgeons and scientists in surgery using heart-lung machines. In 1962 following the death of a child whilst repairing a [[ventricular septal defect]] with the assistance of a heart- lung machine, Sen made his third and final overseas Rockefeller tour which included Japan, Mexico, much of the U.S. and the United Kingdom. He concluded in Moscow with a visit to Demikhov, who had recently achieved fame with his dog heart and head transplants. This came at a time when the Indian government was "actively cultivating ties to the Soviet Union".<ref name="Jones2018" />

===First Indian human heart transplant===
Sen and his team tested their techniques on hundreds of dogs between 1962 and 1964.<ref name="Jones2018"/><ref name=NewsMinute2015>{{Cite news|url=https://www.thenewsminute.com/article/hand-god-story-indias-first-successful-heart-transplant-private-hospital-35890|title=Hand of God: Story of India's first successful heart transplant in a private hospital|date=2015-11-11|work=The News Minute|access-date=16 September 2018}}</ref> In 1965, three out of five dogs who underwent [[heart lung transplant|cardiopulmonary transplants]] were able to breathe after surgery without [[artificial ventilation]]. All the dogs had survivals from 5 to 12 hours.<ref>{{Cite journal|last=Cooper|first=D. K. C.|date=1 July 1969|title=Transplantation of the heart and both lungs: I. Historical review|journal=Thorax|language=en|volume=24|issue=4|pages=383–390|doi=10.1136/thx.24.4.383|pmid=4978618|issn=0040-6376|pmc=472000}}</ref>

James Hardy, who had previously supervised Sen on his first fellowship at Pennsylvania in 1950, had by 1964 transplanted a chimpanzee heart into a human. Two years later, Hardy visited Bombay and spoke at G.S. Medical College about transplants.<ref name="Jones2018"/>

On 16 February 1968, Sen led the team that performed the first human [[Heart transplantation|heart transplant]] in India, and only the sixth in the world.<ref name=":Mittal2002"/> He was the fourth surgeon in the world to attempt this, the previous three surgeons being [[Christiaan Barnard]], [[Norman Shumway]] and [[Adrian Kantrowitz]].<ref name="Jones2018">{{Cite journal|last1=Jones|first1=David S.|last2=Sivaramakrishnan|first2=Kavita|date=10 January 2018|title=Transplant Buccaneers: P.K. Sen and India's First Heart Transplant, February 1968|url=https://academic.oup.com/jhmas/article-abstract/73/3/303/4797400?redirectedFrom=fulltext&login=false|journal=Journal of the History of Medicine and Allied Sciences|language=en|volume=73|issue=3|pages=303–332|doi=10.1093/jhmas/jrx059|pmid=29329407|url-access=subscription}}</ref> The recipient was a male farmer with severe progressive [[cardiomyopathy]] who had been admitted to hospital in the previous six months. It took one month from the decision to transplant to find a donor.<ref name="Jones2018"/> The patient was to be given the heart of a 20 year old [[Maharashtra|Maharashtrian]] woman who had sustained severe head injuries after falling from a train. The operation began just after midnight on 17 February 1968.<ref name="Jones2018"/> The farmer died from heart failure within three hours of the operation.<ref name=":Kalra2016">{{Cite journal|last1=Kalra|first1=Aakshi|last2=Seth|first2=Sandeep|last3=Hote|first3=Milind Padmaker|last4=Airan|first4=Balram|date=1 May 2016|title=The story of heart transplantation: From cape town to cape comorin|journal=Journal of the Practice of Cardiovascular Sciences|language=en|volume=2|issue=2|pages=120|doi=10.4103/2395-5414.191525|doi-access=free}}</ref><ref name="Sabharwal2007"/> The operation was not publicised as widely as previous heart transplants, particularly those of Barnard and Shumway.<ref name="Life1968">[https://books.google.com/books?id=41QEAAAAMBAJ&pg=PA75 "Search for an Ethic"] by Albert Rosenfeld, ''Life'', 5 April 1968, p. 75. Retrieved 20 May 2018.</ref> With less media coverage than numerous other early heart transplants, Sen's heart transplant in February 1968, was before any in Europe, Canada, Australia, Japan or the Soviet Union.<ref>{{Cite web|url=https://thewire.in/the-sciences/50-years-ago-indias-first-heart-transplant-in-the-time-of-nehruvian-science|title=50 Years Ago: India's First Heart Transplant in the Time of Nehruvian Science|website=The Wire|access-date=16 September 2018}}</ref>

Sen believed India had a vast potential as a transplant centre with a wealth of donor organs resulting from accidents on its disordered roads and railways.<ref name="Jones2018"/>

On 13 September 1968, he performed the second human heart transplant in India. The donor was a 25 year old road traffic accident victim and the recipient, a youth. Severe [[pulmonary hypertension]] developed within a few hours of the operation and the recipient died within 14 hours. No further attempts at heart transplants were made in India until [[Panangipalli Venugopal]] led the first successful heart transplant in India, at the [[All India Institute of Medical Sciences, Delhi|All India Institute of Medical Sciences]] (AIIMS) in Delhi in 1994 and after new laws had been passed relating to "brain death".<ref name=":Kalra2016"/><ref name="Sabharwal2007">{{cite book|last=Sabharwal|first=Gopa |title=India Since 1947: The Independent Years|url=https://books.google.com/books?id=LKySGJAGVEQC&pg=PA119|year=2007|publisher=Penguin Books |location=New Delhi|isbn=978-0-14-310274-8|page=119}}</ref>
KEM did not carry out any further heart transplants until 2015.<ref>{{Cite news|url=https://www.hindustantimes.com/mumbai/22-year-old-gets-mumbai-s-first-heart-transplant-since-1968/story-yqgpNHAPKHIbqPhX3146VK.html|title=22-year-old gets Mumbai's first heart transplant since 1968|date=3 August 2015|work=Hindustantimes|access-date=20 May 2018|language=en}}</ref>

===1970s===
Sen's contributions to the procedure of myocardial acupuncture in [[ischaemic heart disease]] were followed by developments in [[aortic arch]] replacement. His students included [[Sharad Panday]], [[M. S. Valiathan]] and [[S. I. Padmavati]] and he maintained contact with heart surgeons outside India such as William Bigelow, [[Denton Cooley]], [[Donald Ross (surgeon)|Donald Ross]], [[Norman Shumway]] and Demikhov.<ref name=":Mittal2002"/><ref name="ASI">{{Cite web|url=http://asiindia.org/dr-p-k-sen-memorial-oration/|title=Dr. P. K. Sen Memorial Oration – The Association of Surgeons of India|website=asiindia.org|language=en-US|access-date=19 May 2018}}</ref>

===Calcutta Hospital and Research Centre===
From 1977, Sen practiced as a consultant cardiovascular and thoracic surgeon at Calcutta Hospital and Research Centre, where he remained until his death in 1982.<ref name=":Obituary1982"/>

Sen received the Indian [[Padma Bhushan]] award.<ref name=":Mittal2002"/><ref name="Jones2018" />{{when|date=February 2026}}

==Personal life==
In 1950, Sen met Marie Barnes, an American physiologist from Philadelphia, while training there. They married in 1954. They had no children.<ref name=":Mittal2002"/>

He painted and wrote poetry. His paintings were displayed at one time in the United States, and twice in India.<ref name=":Mittal2002"/>

==Death and legacy==
Sen died on 22 July 1982 from a [[heart attack]].<ref name=":Mittal2002"/> The department of cardiothoracic surgery at KEM was founded by him and now bears his name.<ref name="ASI"/> As a past president of the [[Association of Surgeons of India]], the "Dr P. K. Sen memorial oration" was established in his honour in 1993 by the [[Indian Association of Cardiovascular-Thoracic Surgeons]].<ref name="ASI"/><ref name="PKSenMemorillectures">{{Cite news|url=http://iacts.org/orations-and-fellowships/p-k-sen-memorial-lecture/|title=P K Sen Memorial Lecture - IACTS|work=IACTS|access-date=16 September 2018|language=en-US}}</ref>

==Selected publications==
* {{cite journal | pmid = 14063008 | doi=10.1136/hrt.25.5.610 | volume=25 | title=The middle aortic syndrome| pmc=1018042 | year=1963 | journal=Br Heart J | pages=610–8 | last1 = Sen | first1 = PK | last2 = Kinare | first2 = SG | last3 = Engineer | first3 = SD | last4 = Parulkar | first4 = GB| issue=5 }}
* {{cite journal | pmid = 5318259 | volume=53 | title=Homologous canine heart transplantation: a preliminary report of 100 experiments | year=1965 | journal=Indian J Med Res | pages=674–84 | last1 = Sen | first1 = PK | last2 = Parulkar | first2 = GB | last3 = Panday | first3 = SR | last4 = Kinare | first4 = SG| issue=7 }}
* {{cite journal | doi = 10.1016/0002-9149(68)90178-1 | volume=22 | title=Human heart homotransplantation∗ | year=1968 | journal=The American Journal of Cardiology | pages=826–832 | last1 = Sen | first1 = Prufalla K.| issue=6 | pmid=4880227 }}.
* {{cite journal | pmid = 14321516 | volume=50 | title=Transmyocardial acupuncture: A new approach to myocardial revascularization | year=1965 | journal=J Thorac Cardiovasc Surg | pages=181–9 | last1 = Sen | first1 = PK | last2 = Udwadia | first2 = TE | last3 = Kinare | first3 = SG | last4 = Parulkar | first4 = GB | issue=2 | doi = 10.1016/s0022-5223(19)33205-2| doi-access = free }}

==References==
{{Reflist|2}}

{{Authority control}}

{{DEFAULTSORT:Sen, P. K.}}
[[Category:20th-century Indian medical doctors]]
[[Category:1915 births]]
[[Category:1982 deaths]]
[[Category:University of Mumbai alumni]]
[[Category:Indian transplant surgeons]]
[[Category:Medical doctors from Kolkata]]
[[Category:History of transplant surgery]]
[[Category:Recipients of the Padma Bhushan in medicine]]
[[Category:1968 in medicine]]
[[Category:20th-century Indian surgeons]]
[[Category:Bengali Hindus]]

P. K. Sen (surgeon) - Revision history

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