In 1968, the US was a divided nation. Riots, bombings, and protests over the Vietnam War were constant. In Richmond, the power struggle between the white establishment and African Americans made the news nearly every day. A burning cross was thrown into the backyard of an African American in the city.

At MCV’s commencement that year, Lower gave a talk on the heart transplant. However, Klett’s condition was declining. Organ rejection can take two forms: acute and chronic. If caught early, acute rejection can be managed with immunosuppressants. However, the treatment is not effective for chronic rejection. Although Klett had acute rejection and received immunosuppressants, the treatment was not effective. Lower learned from this case that heart recipients need higher doses of immunosuppressants than kidney recipients do. The latter have already lost some of their body’s natural immune response. Klett died on June 1, one week after the surgery.

In 1968, only 10 of 104 patients who had heart transplants survived. In the subsequent three years, 24 of 170 survived. The problems occurred after surgery because of organ rejection. Nevertheless, the pace of heart transplants accelerated around the world.