Baby Fae Stuns the World

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Baby Fae, who had no defects other than her hypoplastic heart, was the first infant to come to Bailey's attention who met the criteria for his experiment. As in the case of the late Barney Clark, who in 1982 became the world's first recipient of a permanent artificial heart, an elaborate consent form had been prepared. Fae's parents signed the form once, then thought over their decision for 20 hours before signing it the required second time. According to the hospital, the couple were well informed of the risks and the alternatives.

Meanwhile, Sandra Nehlsen-Cannarella, a transplantation immunologist brought in from New York City's Montefiore Medical Center, conducted five days of laboratory tests to determine which of six baboons at Loma Linda most closely matched Baby Fae's tissue type. However, before the tests were complete, the infant's heart suddenly deteriorated and her lungs filled with fluid. The dying child was swiftly transferred to a respirator and given drugs to keep her blood circulating. The measures were able to sustain her long enough for a baboon donor to be chosen and surgery to begin.

Following what is now standard practice in heart transplants, Bailey transferred his tiny patient to a heart-lung machine, using it to gradually lower her body temperature from 98.6° F to about 68° F. The lower temperature slowed the baby's metabolism, allowing her other organs to better tolerate a reduced blood flow. One hour and 45 minutes into the operation, Bailey descended three floors to the basement, where the hospital maintains a colony of 29 primates. There, he removed the walnut-size heart of a seven-month-old female baboon, the animal that had proved to be the best match for Baby Fae, and placed the organ in a cold saline "slush." Elapsed time: 15 minutes.

Back in the operating room, Bailey removed Fae's defective heart and replaced it with the heart from the baboon. Because baboons have only two major arteries leaving the aortic arch, as opposed to the three in humans (see diagram), two of the baby's vessels were first joined together before being connected to one of the two arterial openings in the baboon's aorta. When the delicate plumbing job was completed, doctors slowly raised the infant's temperature and weaned her from the heart-lung machine. At 11:35 a.m. on Oct. 26, four hours and five minutes after Baby Fae had first entered surgery, her new heart began to beat spontaneously. "There was absolute awe," recalls Nehlsen-Cannarella. "I don't think there was a dry eye in the room."

Baby Fae was not the first person to receive the heart of an ape. In 1964, when heart transplants were a new idea, University of Mississippi Surgeon James Hardy replaced the heart of a 68-year-old man with that of a chimpanzee, but the patient died within a few hours. In 1977 Christiaan Barnard, the South African pioneer of heart transplants, made two attempts to use simian hearts: in a 26-year-old woman, who survived for only six hours, and in a 59-year-old man, who died four days after surgery. In each case, Barnard "piggybacked" the animal organ onto the patient's own heart to act as a supplementary pump. He decided to abandon the technique because of the poor results and the risks of becoming "emotionally attached" to donor chimpanzees, which, he says "are very much like humans." Barnard is nonetheless enthusiastic about the Baby Fae case and has no qualms about the use of baboons, which, he says, are shot on sight by South African farmers, who consider them a nuisance. Perhaps the strangest example of simian-human surgery was tried in 1975 by Cardiologist Magdi Yacoub in England. In an effort to sustain the life of a one-year-old boy during extensive surgery, Yacoub connected the child's circulatory system to the heart of a living baboon. Both the boy and the animal died during the procedure.

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