Her death from cardiac arrest was found to be due to an imbalance of electrolytes, possibly due to the excessive urination observed following chimpanzee kidney transplantation (frequently greater than 20 liters per day), as the chimpanzee kidneys probably did not work in precisely the same way as human kidneys. At autopsy, it was surprising that her transplanted kidneys did not show any signs of rejection and appeared normal. Later, the notion of using nonhuman primates as kidney donors was expanded by a number of surgeons, particularly by Tom Starzl. In 1963, James Hardy, who had carried out the first human lung allotransplant, visited Reemtsma and was impressed by the outcome of the chimpanzee kidney transplantations. Hardy went on to transplant a chimpanzee heart into a human, however, they survived only a few hours. In 1964, at the American Surgical Association meeting in Hot Springs, Virginia, where he presented Tulane's experience of early xenotransplants, including the one patient surviving nine months, he was met with mixed emotions. However, his work gained him a promotion to full professor in 1966. He remained sceptical of the persistent opposition to innovation. First artificial heart Between 1966 and 1971, Reemtsma assembled the team that eventually developed the first artificial heart. He was chairman of the Department of Surgery at the University of Utah at the time, a position appointed to him in 1966. He recruited Willem Kolff, the surgeon who, as a young doctor in the Nazi-occupied Netherlands during the Second World War, invented the first dialysis machine using sausage casings and an automobile water pump part. Both were key players in the assembling of the ideal team of surgeons and engineers that eventually implanted the first artificial heart. New York-Presbyterian Hospital transplant services Reemtsma then moved again to become chairman of the Department of Surgery at NewYork–Presbyterian Hospital and the Columbia University College of Physicians and Surgeons from 1971 to 1994. He had an overarching vision that surgery should be transformed from a predominantly destructive discipline of incision, excision, and amputation to a creative discipline of reconstruction, repair, replacement, and renewal. In 1971, whilst at Columbia-Presbyterian Medical Center (the Hospital was renamed in 1998), Reemtsma recruited surgeon Mark A. Hardy, who in turn established the programme for dialysis and kidney transplantation and started the shared clinical care between renal transplant surgeons and renal physicians, at a time when the two faculties were considered separate.