How Much Is Scientific Lesson Worth? : Doctors Debate Baby Fae’s Legacy
On a stormy Thursday evening, a month-old, curly haired girl known as Baby Fae ended her 20-day struggle to live with a baboon’s heart. She left the medical world a legacy of disputed value.
In a United Press International survey, cardiac specialists, transplantation surgeons and immunologists disagreed over the worth of the scientific lessons that emerged from the highly experimental case.
The publicity-shy surgeon who performed the pioneering procedure Oct. 26 at Loma Linda University Medical Center, Dr. Leonard Bailey, insists that the effort to save the child’s life has not been in vain.
Bailey, who said he plans to perform additional baboon-to-baby heart transplants “by and by,” believes Baby Fae bequeathed to doctors a treasure trove of data that may prove invaluable to other desperately ill infants.
Some other experts agree that knowledge gained from the infant’s experience with the walnut-sized simian heart may indeed make a contribution toward helping other heart disease victims. But they question its magnitude.
Just an Experiment? Others bluntly describe the controversial surgery as nothing more than an interesting experiment that likely will have little, if any, effect on the future course of cardiac research.
All caution that their assessments are based on limited available information, since Bailey and his team are still preparing full reports for submission to various scientific journals.
Baby Fae, whose identity remains secret, was born Oct. 14 with a genetic defect that strikes one in 12,000 babies. Hypoplastic left-heart syndrome left her with half a heart and virtually no chance to live.
She progressed nicely for two weeks after becoming the fourth human and first infant to receive a simian heart. On the 14th day, however, her tiny body began showing signs of rejecting the alien tissue--the greatest hazard in transplantations. She died six days later, on Nov. 15.
Bailey, the 41-year-old surgeon who has led a decade-long crusade to promote cross-species transplants, said during his second and last news conference, “We are remarkably encouraged by what we have learned from Baby Fae.”
He declined to give details about immunological data gleaned from the infant’s short fight--including several new tests to detect and monitor rejection--until formal publication of his research. But he said the lessons of Baby Fae will pave the way for future baboon heart transplants.
“Infants with heart disease yet to be born will some day soon have the opportunity to live, thanks to the courage of this infant and her parents,” Bailey said.
Dr. Robin Doroshow, a Loma Linda pediatric cardiologist, said baboon hearts may offer hope to infants born with Baby Fae’s defect and, eventually, to children with such heart problems as an extremely weak cardiac muscle.
Other scientists said the case does not appear to open the wide horizons created by the first heart transplant in 1964--also an ape’s organ into a human--or of the first permanent artificial heart implant in 1982. Neither recipient lived long, but both events foretold great advances in heart transplant surgery.
“I doubt there will be a major body of knowledge that will be coming from this that is comparable to, say, the discovery of monoclonal antibodies,” said Dr. Randall Morris, chairman of cardiovascular transplant immunology at the Stanford University Medical Center.
Monoclonal antibodies are special proteins that attack diseased cells without harming healthy ones.
“It is of some interest that a baboon heart was able to be surgically implanted in a very young child, but I do not find this a particularly historic case,” he said.
He noted that 20 years ago--before the anti-rejection drug cyclosporine-A was available, before complex tissue matching tests were available, before there was much experience in general in transplantation--a human with a baboon kidney lived three months.
