BY JEREMY SLAYTON

Times-Dispatch Staff Writer

Dr. Richard Rowland Lower was a giant in the field of heart surgery.

He was pioneer as a heart-transplant surgeon, but many people outside the medical profession may not have been aware of it.

Dr. Lower, who participated in almost 400 heart transplants during his career, didn't boast about the part he played in the discovery that heart transplantation was a reality. Today, almost 3,000 heart transplants are performed worldwide annually.

He was honored in April by the International Society for Heart and Lung Transplantation for his contributions to heart-transplant surgery.

Dr. Lower died of metastatic pancreatic cancer Saturday at his ranch in Twin Bridges, Mont. He was 78.

"What I saw in him was a passion for helping people," said Dr. Sheldon M. Retchin, chief executive of Virginia Commonwealth University Health System and vice president for health sciences at the university.

Dr. Lower performed his first transplant -- and the ninth in the United States -- on May 25, 1968.

He faced a wrongful-death lawsuit afterward from the family of the donor, resulting in a landmark case in which a jury decided that brain death could be a criterion of death. That led to changes in laws allowing brain-dead patients on respirators to be potential organ donors.

Years later, Dr. Lower remained "emotionally struck by the memory that the patient didn't survive long" after the first transplant because the new heart was rejected, Retchin said.

Leading up to his first transplant, the Detroit native put in years of work and experimentation that proved transplants were possible. As a surgeon at Stanford University Hospital, he worked with the late Dr. Norman Shumway and performed the first heart transplant on a dog in 1959.

Dr. Lower and Shumway showed the heart could be stopped by cooling it down, allowing them to work on it. Then they used heat to start the heart beating again.

In 1966, Dr. Lower was recruited to the Medical College of Virginia, now VCU Medical Center, to start the human heart-transplant program there. In the fall of 1966, Dr. Lower was poised to perform the world's first heart transplant but believed it wasn't the right thing to do because of blood incompatibility between the patient and donor, said Dr. Marc R. Katz, who studied under Dr. Lower.

Early in 1967, Dr. Christiaan Barnard, a South African surgeon, spent several months at MCV and visited Dr. Lower to observe his transplant procedures. On Dec. 3 of that year, Barnard performed the first human heart transplant in Cape Town.

In his 2006 book, "Every Second Counts," Donald McRae chronicled the race to perform the world's first human heart transplant.

Dr. Lower wasn't seeking the glory that came with being the first surgeon to perform a human heart transplant.

"There was no ego there. He was all about the team and taking care of the patients," Retchin said.

Despite the high stress that comes with performing heart surgery, Dr. Lower was a calming influence on his patients. Ed Graziano underwent a triple coronary bypass in December 1975, when that surgery was in its infancy.

"He'd look you in the eye, put a hand on your arm . . . and you could tell everything was going to be OK," Graziano said.

Dr. Lower, described by those who knew him as friendly and easy to talk to, retired from MCV in 1989 as a professor emeritus and former chairman of the division of cardiothoracic surgery. He left Richmond to become a full-time rancher in Montana. He was an avid outdoorsman and enjoyed fly-fishing.

After suffering numerous broken bones working on the ranch, Dr. Lower returned to Richmond and, at the age of 70, he passed the Federal Licensing Exam. He then volunteered as a general practitioner for the Cross Over Ministry, providing health care for needy people.

Dr. Lower's survivors include his wife, Anne Rutherford Lower of Richmond; three sons, Frederick A. Lower II and Glenn W. Lower, both of Middlebury, Vt., and Gavin R. Lower of Hampden-Sydney; a daughter, Hilary Richardson of Keene, N.H.; a brother, Frederick A. Lower of Mount Dora, Fla.; and seven grandchildren.

A memorial service will be held May 28 at 11 a.m. at St. Mary's Episcopal Church, 12291 River Road in Goochland County.