A baboon-heart transplant inspires both awe and anger
Except for the gauze-covered wound stretching almost the length of her torso, the tiny, dark-haired baby girl might have been just any infant. Lying in her crib with a pacifier close at hand, she gave a couple of gaping yawns. She delicately stretched her scrawny arms in weariness. And mostly she slept. But last week, as television viewers got their first glimpse of the newborn known only as Baby Fae, it was her visibly heaving chest that stole the show. There was no mistaking the pulsations of life and no forgetting that the power source was the freshly implanted heart of a young baboon.
One week after the historic transplant operation at Loma Linda University Medical Center in Southern California, the first infant—though not the first person—to receive a simian heart was reported to be doing remarkably well. "All vital signs are still good, and there's no sign of rejection," said Hospital Spokeswoman Patti Gentry, noting that Baby Fae was "just gulping down her formula." Outside the hospital, there was wonder and excitement over this latest medical marvel, but the enthusiasm was dampened somewhat by controversy. Antivivisectionists around the country and abroad protested what they called "ghoulish tinkering" with human and animal life. "This is medical sensationalism at the expense of Baby Fae, her family and the baboon," charged Lucy Shelton of People for the Ethical Treatment of Animals. The group was one of several that demonstrated outside the Loma Linda hospital last week.
The medical community, though normally receptive to technical innovation, was sharply divided. "There has never been a successful cross-species transplant," declared University of Minnesota Surgeon John Najarian, one of the country's leading pediatric-transplant specialists. "To try it now is merely to prolong the dying process. I think Baby Fae is going to reject her heart." Others defended the experiment. "It's very easy to sit back and be negative when a new treatment is announced," said Dr. John Collins, chief of cardiac surgery at Boston's Brigham and Women's Hospital. "If we all were afraid to attempt the untried, we would have no new treatments."
Little is known about the 5-lb. object of all this controversy or how she came to be the subject of so dramatic an experiment. Loma Linda officials have refused to reveal the child's real name, the identity of her parents or even her exact age. They did say that she was about two weeks old at the time of surgery and had been born three weeks premature. Baby Fae was referred to Loma Linda by a pediatrician in Barstow, Calif. The 546-bed facility is one of more than 60 U.S. hospitals operated by the Seventh-day Adventist Church and has a fine reputation in pediatric heart surgery. Fae was suffering from hypoplastic left-heart syndrome, a fatal condition said to affect one in 12,000 newborns. In children with this defect, the left side of the heart, including its main pumping chamber, the left ventricle, and the aorta, is seriously underdeveloped. In Fae's case, doc tors said, the left side of the organ was virtually nonexistent.
Dr. Leonard Bailey, 41, the pediatric cardiac surgeon who treated Fae, over the years had seen dozens of infants with this defect die, generally within two weeks of birth. While a transplant from a human donor could theoretically be used to help such babies, Bailey was discouraged by the drastic shortage of infant hearts. Seven years ago he began investigating the possibility of using hearts from other species, or xenografts. He performed more than 150 transplants in sheep, goats and baboons, many of them between species. Last December, after what Bailey called "months of agonizing," the Loma Linda institutional review board gave him preliminary approval to implant a baboon heart in a human infant. The final go-ahead came just two days before Baby Fae's surgery. "There is evidence that the chimpanzee, orangutan or gorilla may be a better donor," Bailey noted last week, "but they are either an endangered species or don't procreate well in captivity."