OBITUARY

Professor John Terblanche - 1935-2023

Professor John Terblanche, internationally recognised as one of the world's leading researchers in the treatment of liver diseases, died in Cape Town on 6 March 2023, aged 87 years.

Terblanche, a previous Head of the Department of Surgery at the University of Cape Town and Groote Schuur Hospital from 1981 to 2000, graduated from the University of Cape Town in 1958 and qualified as a surgeon in 1964 when he was awarded the Douglas gold medal as the best graduate of the year. He started his surgical career by doing pioneering research with Professor Christiaan Barnard using the heart-lung machine and bubble oxygenator to cool patients during cardiac surgery for which he was awarded a ChM with distinction in 1964. He spent the following two years in Bristol with Joe Peacock where he perfected the technique of orthotopic liver transplantation in Landrace swine. On his return to Cape Town, he subsequently co-founded the MRC Liver Research Centre in 1973 with Professor Stuart Saunders, a position he shared later with Professor Ralph Kirsch. This resulted in a highly productive and collaborative research partnership which produced key findings and highly cited international publications. These included the early seminal work on baboon-to-human exchange transfusion by cross circulation for fulminant hepatic failure and the discovery in pigs of Dantrolene as the treatment of choice for malignant hyperthermia, successfully applied later in patients.

Professor Terblanche was appointed head of the Department of Surgery at the University of Cape Town at the relatively young age of 45 years. Larger than life and a force of nature, he was highly regarded as a clinician, researcher, and educator, but his biggest international contribution was the visionary and pioneering leadership he brought to the life-saving endoscopic treatment of bleeding oesophageal varices. The Cape Town prospective and randomised controlled trials revolutionised and introduced the modern treatment of variceal bleeding, publications which are among the most cited studies in the history of portal hypertension.

Leading by example, he transformed an excellent department inherited from his predecessor, the formidable and legendary Professor Jannie Louw, into an outstanding one, equal to the finest in the world. His abiding interest in liver disease led to the establishment of a research programme, which became a mecca for liver surgery training and attracted international visitors to Cape Town who later returned home, spreading the gospel according to Terblanche, entrenching his global reputation and legacy. His boldness and confidence allowed him to challenge conventional and orthodox teaching and the prodigious output from his strong and stable research team, of whom he demanded meticulous scientific rigour and unalloyed integrity, elevated the importance of South African liver research to an international audience.

John Terblanche was the editor of four books, 109 invited textbook chapters and over 260 highly cited peer-reviewed publications. He was an ardent ambassador for South Africa and a popular speaker at international meetings for over two decades. A staunch and eloquent advocate for the continued support of surgical research, many benefited from his wise counsel and he took great pride in the successes of his proteges. His personal qualities included principled and decisive leadership, inexhaustible energy and enthusiasm and a taxing work ethic in which he led from the front when others flagged or wilted.

He had a global influence and the national and international esteem in which he was held is reflected by the award of an honorary Fellowship from each of the ten Surgical Colleges and Associations in the world. He delivered a raft of international eponymous lectures and was visiting professor at 43 universities in 28 countries globally. He held high office in numerous distinguished societies and was President of various international bodies including the International Federation of Surgical Colleges (1997-2000), the International Association for the Study of the Liver (1996-1998) and the Pan African Association of Surgeons (PAAS) (2000-2002). In South Africa, he was President of the College of Medicine (1989-1992), the Association of Surgeons of South Africa (1992-1995), the Surgical Research Society of Southern Africa (1986-1988) the Southern African Transplant Society (1979-1981) and the Pan African Association for the Study of the Liver (1982-1984). He was an active Vice-Chairman of the South African Medical Association from 1989 to 2000.

John Terblanche will be long remembered by many as the consummate clinician-researcher-academician but also as a kind and generous teacher and mentor. His legacy is set to endure, and surgeons, both local and abroad, remain indebted to him for his vision, values, vigorous leadership, innovative scientific contributions and the standards of excellence he practised and demanded. His influence was immense and will last beyond his physical presence. Isaac Newton's words could not be more apt as those who worked with him could see further because they stood on the shoulders of an academic giant.

His continued love for his family was a cornerstone in his life. Anne, John's loving wife for more than 60 years, was a constant supporter of his career and a gracious hostess to the innumerable visitors, ranging from distinguished international visitors to junior trainees, invited to dine at the Terblanche home. Our thoughts and sympathies go to Anne, his children James, Michelle, Michael and Christopher, and their spouses and grandchildren.

Emeritus Professor Jake Krige