Baby Fae Stuns the World

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The surgeon from Takoma Park, Md., has devoted his career to trying to help victims of hypoplastic heart. A Seventh-day Adventist, he was educated at Loma Linda University Medical School, the only Adventist medical college in the world. Bailey had first considered using xenografts during his residency at Toronto's Hospital for Sick Children, where, he admits, the idea "drew snickers." When he tried to develop the procedure at Loma Linda, he found it difficult to get his research papers published and impossible to get funding. "I felt rather lonely," he reflected last week. "People didn't understand the importance of this; they weren't watching babies die." Ultimately a research fund was set up by 20 physicians at Loma Linda, who contributed part of their salary each month. In seven years they raised more than $1 million.

While some religious groups find the idea of animal-to-human transplants repugnant, it is not inconsistent with Seventh-day Adventist teachings, says Dr. Jack Provonsha, a minister of the church as well as a doctor at Loma Linda. The church has always placed a strong emphasis on health. This, he explains, is part of the belief that "our redemptive concern for man's need should include not only his spiritual life but his physical life as well." Because Adventists see man as "the ultimate level of our value concerns," says Provonsha, "then the sacrifice of an animal for the sake of the life of a baby is acceptable, even though we value animal life as well."

By week's end Baby Fae's remarkable progress was making many critics of the experiment think again. Loma Linda doctors expressed relief that their tiny patient had so far avoided "hyperacute rejection," a reaction to foreign tissue that often occurs immediately after a transplant. However, Hinshaw cautioned that the seventh to tenth days after a transplant are a peak period for rejection. Should the child begin to show signs of rejecting the baboon heart, said Hinshaw, a second transplant would be considered. In this event, a human heart was said to be the team's first choice and another baboon organ would be the second.

Even if Fae does not reject her new heart, she might ultimately need a replacement. Though Dr. Bailey's animal research suggests that a xenograft adjusts to the needs of its new host, no one really knows what to expect. Also unknown is the long-term effect of cyclosporine, which Fae may have to take for the rest of her life. The drug has been found to cause liver and kidney damage and to increase the risk of certain cancers.

Loma Linda hospital has given Bailey permission to try five baboon-to-human transplants, but doctors say they have no immediate plans for other patients. Last week they were referring parents to Dr. Norwood at Children's Hospital of Philadelphia. Already some optimists are envisioning a day when the transplanting of simian hearts will be as acceptable in human medicine as the use of heart valves from pigs and bovine insulin. "Maybe one of these days we can start farming baboons for this purpose," suggests Christiaan Barnard. Others believe that baboon hearts could be used as a temporary measure, to gain time for patients who are awaiting human donors.

As the possibilities unfolded, many wondered what life would be like for a human with the heart of a monkey.

Asked whether Baby Fae would have trouble adjusting and perhaps be teased for being different, Loma Linda's Hinshaw replied, "Society may have to adjust to her." The heart, he added dryly, "is only a muscular pump. It is not the seat of the soul.''

Reported by Steven Holmes/Los Angeles, with other bureaus

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