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Baby Fae, infant who received baboon heart transplant, dies

Baby Fae, infant who received baboon heart transplant, dies



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“Baby Fae,” a month-old infant who had received a baboon-heart transplant, dies at Loma Linda University Medical Center in Loma Linda, California.

The infant, named Baby Fae by doctors to protect her parents’ anonymity, was born with hypoplastic left-heart syndrome, an almost always fatal deformity found in newborns in which parts or all of the left side of the heart is missing. A few days after Baby Fae’s birth, Loma Linda heart surgeon Dr. Leonard L. Bailey convinced Baby Fae’s mother to allow him to try the experimental baboon-heart transplant. Three other humans had received animal-heart transplants, the last in 1977, but none survived longer than 3 1/2 days. Bailey argued that an infant with an underdeveloped immune system would be less likely to reject alien tissue than an adult.

On October 26, Bailey performed the world’s first baboon-to-human heart transplant, replacing the 14-day-old infant’s defective heart with the healthy, walnut-size heart of a young baboon. Baby Fae survived the dangerous operation, and her subsequent struggle for life received international attention. After living longer than any other human recipient of an animal heart, Baby Fae’s body made a concerted effort to reject the alien transplant. Doctors were forced to increase dosages of an immuno-suppressive drug, which caused kidney failure. Ultimately, doctors were defeated by the swift onset of heart failure, and on November 15 Baby Fae died, after holding on for 20 days.


1984 Baby Fae dies

MEDICAL CENTER SURGERY OPERATION HEART TRANSPLANT HOSPITAL

“Baby Fae,” a month-old infant who had received a baboon-heart transplant, dies at Loma Linda University Medical Center in Loma Linda, California.

The infant, named Baby Fae by doctors to protect her parents’ anonymity, was born with hypoplastic left-heart syndrome, an almost always fatal deformity found in newborns in which parts or all of the left side of the heart is missing. A few days after Baby Fae’s birth, Loma Linda heart surgeon Dr. Leonard L. Bailey convinced Baby Fae’s mother to allow him to try the experimental baboon-heart transplant. Three other humans had received animal-heart transplants, the last in 1977, but none survived longer than 3 1/2 days. Bailey argued that an infant with an underdeveloped immune system would be less likely to reject alien tissue than an adult.

On October 26, Bailey performed the world’s first baboon-to-human heart transplant, replacing the 14-day-old infant’s defective heart with the healthy, walnut-size heart of a young baboon. Baby Fae survived the dangerous operation, and her subsequent struggle for life received international attention. After living longer than any other human recipient of an animal heart, Baby Fae’s body made a concerted effort to reject the alien transplant. Doctors were forced to increase dosages of an immuno-suppressive drug, which caused kidney failure. Ultimately, doctors were defeated by the swift onset of heart failure, and on November 15 Baby Fae died, after holding on for 20 days.


Infant Who Received Heart Transplant Dies

An 8-week-old girl who last week had been given the heart of another infant died early Saturday, Loma Linda University Medical Center announced.

“Her new little heart was not able to sustain an adequate blood presure, despite maximum support measures,” hospital spokeswoman Anita Rockwell said.

Baby Kari, of Saskatoon, Canada, died four days after receiving a new heart in a four-hour operation performed by Dr. Leonard Bailey, chief of pediatric cardiac surgery. The baby was born with hypoplastic left heart syndrome, a condition in which the side of the heart which pumps blood fails to develop.

The child, whose parents are identified only as Ken, a corrections officer, and Linda, a registered nurse, brought her to Loma Linda soon after she was born. But the newborn had to wait seven weeks until a donor heart could be obtained. No information about the donor was released.

Four of Bailey’s six previous infant heart transplant patients are still living. The longest survivor is Nicholas Anguiano, nicknamed Baby Moses, who celebrated the one-year anniversary of his transplant at a party at Loma Linda last month. Attending the party were Baby Eve, Baby Jesse and Baby Rachel. In 1984, Bailey performed a baboon-to-human heart transplant for Baby Fae, who died 20 days after the surgery.

“Baby Kari and her parents touched the lives of medical center staff and we share in the family’s great sense of loss,” Rockwell said. “The parents wish to express their appreciation for the prayers and support offered by many people.”


Surgeon Tells of ‘Catastrophic’ Decision : Baby Fae’s Death Traced to Blood Mismatch Error

Baby Fae died because of a “catastrophic” medical decision to transplant the heart of a baboon that had a different blood type, the surgeon who performed the operation said Tuesday.

As a result of the blood mismatch, the infant developed antibodies to her own red blood cells, causing her blood to clot, Dr. Leonard L. Bailey of the Loma Linda University Medical Center told the annual meeting of the California Perinatal Assn. here.

When Baby Fae died 20 1/2 days after the transplant, her kidneys were “stuffed” with “abnormal” red blood cells, and thus unable to work, he said.

The failure to match blood types was “a tactical error that came back to haunt us,” Bailey said.

The infant’s blood was type O and the baboon was type AB.

“If Baby Fae had the type AB blood group she would still be alive today,” Bailey said.

The infant was born Oct. 14, 1984, in Barstow with an almost invariably fatal heart disease called hypoplastic left heart syndrome. She received a baboon heart at Loma Linda on Oct. 26, the first infant ever to receive an animal heart transplant.

She was identified only as Baby Fae, at the request of her parents.

Originally, it was thought that rejection of the heart or kidney damage by the anti-rejection drug cyclosporine-A may have caused her death. But the autopsy showed only “minimal” signs of rejection in the heart and no evidence of drug damage to the kidneys, the surgeon said.

In a comprehensive review containing significant new information about the controversial transplant, Bailey also showed a 16-millimeter film of the operation as well as color slides of the autopsy.

The surgeon, who has largely refrained from public comment on the case, appeared relaxed and told several jokes in the course of his 45-minute presentation to more than 200 physicians, nurses and other health care workers. He declined to elaborate or clarify his remarks to reporters after the meeting.

He also provided new details about the immunologic problems he and his team encountered after the surgery.

Bailey said the decision not to match the blood types of Baby Fae and the baboon was based on a mistaken belief that the differences between blood types would be less a problem than the differences between species.

Blood types are determined by proteins on the surfaces of blood cells that vary between individuals. Blood can generally only be transfused between individuals of the same blood type.

Bailey also reasoned that the baby’s immune system was immature and could be blocked by large doses of anti-rejection drugs.

Moreover, baboons with type O blood are rare and Bailey had none available when Baby Fae was dying. “We came to regret all these decision-making processes,” he said.

Bailey said an account of his work would be published by the Journal of the American Medical Assn. A spokesman for the monthly journal said that, as a matter of practice, it does not comment on any articles that may or may not be in the works.

Bailey said Baby Fae’s mother was aware of all the autopsy findings. He said the parents had asked for the autopsy.

He said the mother had read the manuscript of the article for the journal.

The surgeon also said that approval from the Institutional Review Board at Loma Linda for further transplants has “run out” after one year, and a renewal has been applied for.

Bailey said that, in future heart transplants, blood types of the donor and the recipient will be matched and that he would use either human or baboon hearts, “depending on what donors are available.”

Last year some physicians and medical ethicists criticized Bailey for not having searched first for a human heart before implanting the baboon organ in Baby Fae. And Bailey on Tuesday said that it was “an oversight on our part not to search for a human donor right from the start.”

That search began three days after the transplant. No human heart was found before the baby died.

Bailey also defended his continued work in cross-species heart transplantation, reiterating his belief that surgical procedures attempting to treat hypoplastic left heart syndrome, such as the one developed by Dr. William Norwood, are inadequate. This congenital malformation is a condition in which the side of the heart that pumps blood to the body fails to develop.


12 May 2017 by Jasmine Stone in Health, History, Lifestyle, Vibe

Related Posts

Most of the time we try and keep you up to speed with what’s happening today, but every now and again we’ll take a trip down memory lane.

I stumbled across the story of Baby Fae this week, and if you’re not familiar with this one then you’re in for a few surprises.

In 1984 Dr. Leonard Bailey transplanted a baboon heart into an infant named Stephanie Fae Beauclair, and she actually survived for 21 days.

TIME did a piece back in 2015 that covers how this one played out:

Beauclair was born three weeks premature with hypoplastic left heart syndrome, a fatal defect in which the left side of the heart is underdeveloped. Though babies with the condition were expected to live for about two weeks, and Fae’s mother was given the option of letting her die in a hospital or at home, Dr. Bailey [ below, in 2007] had another option in mind.

…no one had yet completed a successful infant heart transplant, mainly due to the lack of infant donor hearts. Given that shortage, Bailey, a pediatric [sic] cardiac surgeon at Loma Linda University Medical Center in California, had spent seven years researching xenografts, or transplants from other species.

Bailey had conducted around 150 transplants between animals of different species before, and there had actually been an example of a human baby receiving a simian heart in 1964.

On that occasion the baby had died within a few hours of the surgery, so it was very much a shot in the dark when Bailey operated on 12-day-old Fae on October 26:

Fae’s “new heart began to beat spontaneously. ‘There was absolute awe,’” recalled Sandra Nehlsen-Cannarella, a transplantation immunologist working on Fae. “I don’t think there was a dry eye in the room”

…Although Fae initially improved steadily, she began to decline 14 days after the transplant and died on Nov. 16, 1984. Upon her death, TIME wrote, “So ended an extraordinary experiment that had captured the attention of the world and made medical history. For three weeks the 5-lb. infant had survived with the heart of a baboon—more than two weeks longer than any previous recipient of an animal heart.”

Less than 12 months later, Bailey would perform the first successful infant heart transplant.

Another case of truth being stranger than fiction, right?

Latest News


BABOON HEART IMPLANT IN BABY FAE IN 1984 ASSAILED AS 'WISHFUL THINKING'

An attempt 14 months ago to save a dying infant by giving her a baboon heart was doomed to failure and the outlook of her surgical team was tainted by ''wishful thinking,'' according to a new medical review of the case.

The comments came in an editorial appearing in Friday's issue of The Journal of the American Medical Association. The infant, known as Baby Fae, died 20 days after the operation.

The journal is publishing the first peer-reviewed scientific account of the Baby Fae operation and its aftermath, although the case has been commented on in previous scientific meetings and other public forums.

In an article in the same issue, Baby Fae's surgeon, Dr. Leonard Lee Bailey of the Loma Linda University Medical Center, said baboon-to-human heart transplants were 'ɺ reasonable investigative option.''

Surgeon Critical of Critics

Dr. Bailey also held a news conference here today in which he replied to the journal editorial, saying the outlook of his critics was tainted by '�'s thinking'' and that their comments were ''patronizing.'' He called upon them to adopt '�'' concepts of transplantation instead of relying on outdated concepts.

The debate is certain to continue. The cause of Baby Fae's death has not yet been determined. According to Sandra L. Nehlsen-Cannarella, an immunologist who works closely with Dr. Bailey, the autopsy showed 'ɺ complicated, unclear picture,'' adding, ''The heart was injured by a combination of factors. It was not rejected in the classical sense.''

Despite the uncertainties, Dr. Bailey said there were compelling reasons to continue experiments in transplanting baboon hearts into human infants.

From 300 to 2,000 infants are born annually with the fatal heart defect hypoplastic left heart syndrome, he said, explaining that such infants are essentially born with half a heart and most die within a few weeks. A corrective surgical technique is being tried on some of these children but, according to Dr. Bailey, the surgery is just as risky as a baboon transplant. Baby Fae was born with this defect.

Another infant with the defect, known as Baby Moses, received a human heart transplant from a brain-dead baby at Loma Linda last month. The baby is making 'ɾxcellent progress,'' Dr. Bailey said, 'ɺnd as of today he is thrilling to watch.''

He said finding a human heart for Baby Moses was a stroke of luck and that human infant donors were extremely scarce. Animal-to-human transplants can fill the gap, he said.

Dr. Bailey's critics say he is well-intentioned but off the mark. In the editorial, Dr. Olga Jonasson of Cook County Hospital in Chicago and Dr. Mark A. Hardy of the Columbia College of Physicians and Surgeons in New York City said not enough was known about crossing the species barrier to warrant more transplants at this time.

Although the operation was technically feasible, they said, a human recipient is destined to form antibodies against a baboon heart and reject it. Antibodies are substances formed by the body to kill agents they recognize as foreign. Adult humans have very specific, preformed antibodies in their bloodstream that recognize baboon tissue as foreign. At this time, they said, there is no way to suppress this antibody activity safely.

Issue of Genetic Similarity

They also said baboons were not close enough to humans, in terms of genetic similarity, to be good candidates as transplant donors. Chimpanzees and gorillas are considered closer, but cannot be bred in large numbers.

They said Dr. Bailey exhibited ''wishful thinking'' in considering Baby Fae's immune system to be immature. The newborn immune system, they said, ''is intact, inexperienced and in some ways functionally deficient, but it is capable of the rejection response.''

Dr. Bailey has also been criticized on ethical grounds. He did not seek a human heart donor before putting the baboon heart in Baby Fae and questions have been raised on how well Baby Fae's parents understood the experiment. Animal rights groups say it is immoral to kill baboons for any medical experiment.

In the future, he said, a human donor will be sought and if none can be found, an animal transplant will be done, either permanently or as a bridge until a human heart can be found.

Wording has been changed on the consent form given to parents to take away any impressions that a baboon transplant would extend life for a ''long term,'' he said.

In the meantime, Dr. Bailey and his team are trying to find out why Baby Fae died. There are two major systems in which the body rejects or kills foreign tissue. Baby Fae's doctors could control one and not the other.

The one they controlled involved cell-mediated rejection in which T-lymphocytes from bone marrow attack cells in the donor heart. This classical type of rejection was suppressed with the use of cyclosporine, a drug credited with making modern transplantation more successful than ever. Baby Fae's heart was not beefy, floppy or swollen, Dr. Nehlsen-Cannarella said, ''which makes us believe the cyclosporine worked.''

But the physicians were not able to control Baby Fae's other rejection mechanism involving antibodies, which are also formed in bone marrow. The autopsy showed her heart was laced with sticky clumps of red blood cells. Her kidneys, liver and lungs were also clogged with this material. #2 Categories of Antibodies At least two categories of antibodies were involved, Dr. Nehlsen-Cannarella said. The first was raised against the red blood cells of the baboon donor. In what Dr. Bailey termed 'ɺ tactical error with catastrophic consequences,'' Baby Fae and the baboon donor had different blood types. By crossing this blood type barrier, he said, antibodies were formed that made any baboon blood introduced into Baby Fae clump and stick together.

This mismatching of blood was avoidable, he said, adding that the mistake will not be repeated.

The second antibody group was directed against baboon tissue in general. The antibodies were gradually absorbed by the baboon heart, which caused sludging of the blood cells and starvation of the heart muscle.

Dr. Bailey said that, unlike adult humans, most babies do not yet have preformed antibodies against baboons. It is this relative immaturity of the immune system, he said, that may help infants better accept organs from another species. Dr. Nehlsen-Cannarella said, however, that such antibodies will be the most difficult to control in future transplants.

Other factors, including injury from the cyclosporine and the possibility that Baby Fae made antibodies that attacked her own red blood cells by mistake, are being explored, the immunologist said. Work with piglet hearts placed in newborn goats is under way at Loma Linda to try to duplicate what happened to Baby Fae.


From the Archive — Baby Fae: As a Wondering World Watched

The stretch and yawn of a small, dark-haired, blue-eyed baby girl who underwent a historic heart transplant at Loma Linda University Medical Center last October captured the hearts of millions of people throughout the world for a few short weeks.

The transplant of a baboon heart into a two-week-old girl by a team headed by Leonard L. Bailey, MD, a 1969 graduate of the School of Medicine, was the first of its kind in a newborn ever attempted. The transplant made front page news in virtually every daily newspaper throughout the United States and around the world in such places as London, Paris, Berlin, Tokyo, Hong Kong, Singapore, Cape Town, and Beijing.

Reaction to the news was immediate—and mixed. The San Diego Union, in an editorial on Saturday, November 3, stated in part that “the great medical team at highly respected Loma Linda University Medical Center has demonstrated medical science at its best, which is to say it was willing to dare failure and controversy to save a life that would otherwise have been lost. And even if Baby Fae does not survive, she and her doctors will have advanced medical knowledge for the ultimate benefit of mankind.”

Other newspaper editorial pages expressed similar opinions. The Dayton, Ohio, Journal Herald said, ”It is easy to be distracted by emotional protests that are beside the point.

"We need to focus, rather, on this reality: a baby girl was born with a severe birth defect—hypoplastic heart syndrome—which made the left side of her heart much smaller that the right side. Had nothing been attempted surgically, her impending death was a certainty….

“Dr. Bailey, his colleagues, and his hospital deserve praise, not condemnation, for trying. Their experiment, born of desperation, may yet be tomorrow’s breakthrough for untold numbers of babies.”

Joanne Jacobs, a columnist in the San Jose Mercury-News, said, “I’m glad Baby Fae got a chance too: trying to save her, even at desperate odds with experimental techniques, was the humane thing to do.

“I wouldn’t want to live in a society that let its children die without a fight.”

While news of the surgery came as a surprise to much of the world, research leading up to it has been going on at Loma Linda University School of Medicine for the past seven years. Since 1977, intensive laboratory research in the area of newborn heart transplantation has been conducted by Dr. Bailey and his colleagues.

During this time, Dr. Bailey transplanted dozens of hearts between subspecies of newborn goats, and grafted lamb hearts into baby goats. With only limited doses of anti-injection drugs to suppress their immune reaction to foreign tissue, the goats with lamb hearts lived as long at 165 days, and went without rejection episodes for up to six weeks.

His work, ultimately pointing to the concept of xenografts (transplanting organs from one species to another) was a viable possibility for human beings, especially those newborns who came to him dying of hypoplastic left heart syndrome.

Baboons, according to Dr. Bailey, might prove to be a better source of new hearts for babies than humans.

According to the January 1985 Discover magazine published byTime, Incorporated, “healthy infant hearts are rare among donated organs, primarily because infant hearts are a principal cause of infant deaths. Baboons are easily obtainable—the common savanna varieties are considered pests in their native Africa, and they breed prolifically in captivity.

“Chimpanzees, gorillas, and orangutans are far rarer, though they are all much closer genetically to people. Baboon hearts are nevertheless very similar to human hearts.”

Data from Dr. Bailey’s research suggested that babies born with hypoplastic left heart syndrome may have the potential for survival by having heart transplantation during the first few days of life.

Even though relatively uncommon, one in 12,000 babies is born with a hypoplastic left heart—300 per year in the United States. Most of these babies are otherwise born healthy. Yet for most there is no hope.

These babies “lack nothing more than a biological pump,” Dr. Bailey says. “Many people don’t understand the importance of this. They weren’t watching babies die.”

New and original information from the University’s surgical research laboratory, coupled with the release of a new immunosuppressive agent—Cyclosporine—has opened the way for the unique clinical studies in xenotransplantation.

These clinical trials have been studied and approved by many university and medical center communities including the Loma Linda University Institutional Review Board, the Loma Linda University Bioethics Center, the Medical Center standing transplantation committee, the departments of surgery and pediatrics in the School of Medicine, and the School of Medicine administration.

Baby Fae was born in the middle of October in a California high-desert hospital. She was diagnosed as having a heart defect and transferred to Loma Linda University Medical Center, where she was found to be suffering from hypoplastic left heart syndrome. Subsequently, following a short release period, Baby Fae was readmitted to Loma Linda University Medical Center, where her parents were fully informed about her condition and presented with various options. After many hours of discussion, the parents selected the xenotransplantation procedure.

On Friday morning, October 26, Baby Fae underwent a five-hour surgery (called a xenograft) in an attempt to correct her lethal heart condition.

At approximately 7:30 that morning she was taken from her intensive-care room on the seventh floor of the hospital to a surgery suite. Her body temperature was lowered from 37C, (98.6 F) to 20C (68 F) with the use of a heart-lung machine. This step slows down body functions and makes it easier for surgeons to perform their surgery.

Prior to her surgery, several days of clinical tests were done to select the primate that was most immunologically compatible with Baby Fae. Six baboons (ranging in age from four to 12 months) were initially selected for the tests. These were narrowed down to two baboons and finally to one after various testing procedures.

The process “yielded one of the most important finding of the entire effort: that a baboon’s heart could be more compatible with a patient’s tissue than some human hearts,” according to Discover magazine.

“This discovery came to light during the days just before the operation, after Sandra Nehlsen-Cannarella, PhD, a highly respected immunologist at New York City’s Montefore Medical Center, arrived at Loma Linda to begin screening the baboons to find tissue most compatible with Baby Fae’s.

“She determined quickly that Baby Fae carried no preformed antibodies to baboons, roughly eight out of ten adults humans carry antibodies.”

Dr. Nehlsen-Cannarella, working with Loma Linda University research immunologist, Weldon Jolley, PhD, also evaluated tissue samples from various humans—Baby Fae’s parents, other relatives, and doctors—and matched with samples from Baby Fae.

Baby Fae showed the strongest reaction against the tissues from the doctors and two of the half dozen baboons. Of the remaining baboons, one stimulated a very low response and became the animal of choice.

Shortly after 9:00 a.m. the preliminary operative steps were completed and Dr. Bailey went to the hospital research laboratory where the anesthetized baboon awaited him. Shortly, he returned to the surgical suite with the baboon’s heart in a container of icy saline slush. Then, Dr. Bailey led the surgical team in removing Baby Fae’s defective heart and substituted its replacement.

Three arteries normally rise from the human aortic arch, a big blood-bearing tube that curves over the top of the heart. But only two such arteries protrude from the baboon’s heart. Dr. Bailey solved the problem by leaving much of Baby Fae’s aorta and its connecting arteries in place, opening the baboon’s arch, and sewing the two together.

After the chest cavity was closed, Baby Fae’s temperature was raised. At 11:35 a.m. her new heart began to beat spontaneously.

The people in the operating room were in awe at what had just happened, according to Dr. Nehlsen-Cannarella. “I don’t think there was a dry eye in the room.”

Following the surgery, Baby Fae was transferred to her intensive care suite, where she was carefully monitored around the clock.

A couple of hours after the surgery, the University and Medical Center began receiving telephone calls from the news medial requesting information about the historic transplant.

In anticipation of this event, the University and Medical Center had established a communication and press center in the University’s Randall Visitor’s Center, equipped with a bank of phones, tables, and electrical outlets for computers and typewriters. During the first few days following the surgery, the public relations staff were answering up to 1,500 telephone calls per day from all around the world—Great Britain, France, Italy, Germany, Switzerland, Japan, Australia, Canada, and virtually every corner of the United States.

Television crews from the major American networks set up satellite stations at the University for live and tape-delayed broadcasts. During the first week following the surgery, approximately 275 representatives of the world press visited Loma Linda.

In addition to the news media, small numbers of anti-vivisectionists and advocates of animal rights groups hurried to Loma Linda with protest signs that were translated into news photos that were transmitted around the world.

Some scientists criticized the Loma Linda team. Transplant specialist, John Najarian, MD, of the University of Minnesota observed, “Everything we know indicates that the heart is going to fail. The operation will merely prolong the dying process."

Other critics noted that the only other recipient of a simian heart—a 68-year-old man who was given a chimpanzee’s heart in 1964 by Mississippi surgeon, James Hardy, MD—died within 90 minutes, and that two patients of Christian Bernard, lived only a few days after he coupled simian organs to their failing hearts in a piggyback procedure.

But there were voices of encouragement. Stuart W. Jamieson, MD, a member of the Stanford University heart transplant team, which is widely regarded as the world’s leader in that specialty, said he was “rather disappointed to hear that people in the scientific community have leveled charges that they (the Loma Linda team) were unprepared.

“I don’t believe that any of that is correct, it was a legitimate and timely thing to do.”

In answer to the charges that the Loma Linda team had not sought a human heart before transplanting the baboon heart into Baby Fae, Dr. Jamieson said, “Clearly a human heart would be preferable.” He went on to say that he did not want to be critical of the Loma Linda team, because finding a suitable human heart for Baby Fae the day she needed the operation would have been virtually impossible.

Other scientists concurred with Dr. Jamieson. William DeVries, MD, who implanted the heart in Barney Clark and later William Schroeder said that “we’re watching medical history every day that child lives,” and professed smpathy for what they’re going through.

Following the surgery, the hospital mobilized to insure that Baby Fae remained healthy. After Dr. Bailey’s first press conference (two days following the surgery), he disappeared from the media’s view to keep an almost continuous watch on Baby Fae. A team of physicians, nurses, and other health care specialists monitored her vital signs every moment of the day. Her mother visited her many times a day when she could take Baby Fae out of her hospital crib and hold and fondle her and even rock her in a nearby chair. Space next to her room was set aside for the many toys, cards, and hundreds of letters from a growing body of her fans.

Letters of support for Baby Fae, her parents, and Dr. Bailey poured into Loma Linda. Entire classrooms of school children shared their thoughts and best wishes.

“I’m sending you this card as a sign of courage.” Wrote one sixth-grader from Parker Junior High, in Rocky Mount, North Carolina. “I hope you get better soon."

Another said, “Our class is really sorry about your heart. I hope that we can help you. If I was a little bit younger I would’ve given you my heart because I think babies are nice to have.”

Perhaps the most poignant response came from a mother of a baby girl who died in 1981 of hypoplastic left heart syndrome. In a letter to the surgeon and Baby Fae’s parents, the mother said, “In 1981, I gave birth to a beautiful baby girl that was diagnosed with hypoplastic left heart. I would give anything to trade places with Baby Fae’s parents because I had to watch my beautiful perfect child die in my arms—because at the time there was no surgery to help her.

“I remember saying to the doctors, ‘There’s got to be something you can do.’ So we took our little girl back to begin our agonizing wait. She lived only 24 hours longer. During that 24 hours I still prayed that they were wrong.

“What I am trying to say is that I would gladly trade places with [the parents]. I am glad that now at least Baby Fae has a fighting chance. Our little girl was born a few years too early. I would have given anything to help my baby, as you are doing, even if I had only prolonged her life. You see, all I have left of her is six days of memories—a lifetime crammed into six short days, and I wouldn’t give up that time spent with you for anything.

“My love and prayers are with all three of you at this critical time. And remember, our little baby girls were put on this earth for a reason only God knows. I realize it is very hard to accept what has happened and not lose faith. Hang in there and keep fighting.

“I now have three beautiful healthy children. I often can see a little blond head lined up with my other three. She forever lives in my heart and soul.”

But despite having the best medical care available, Baby Fae died at 9:00 p.m. on November 15.

At a press conference the next day, Dr. Bailey, even though emotionally shattered by Baby Fae’s death—a loss shared by the whole nation—pledged to honor the request of Baby Fae’s mother that this experience not be wasted and that he would attempt the operation again “by and by.”

On Sabbath afternoon following Baby Fae’s death, a memorial service was held at the University Church of Seventh-day Adventists in Loma Linda. Over 2,500 people crowded into the church to pay their respects, many more watched on closed-circuit television.

Baby Fae’s baboon heart failed her. Was it worth it?

Discover magazine believes it was. “In a world where many millions of children are dying for simple want of food, is it right, after all, to spend so much time, effort, and money to try to save one who has so little chance of survival? Perhaps not simply right, but necessary. To cherish the life of one child—‘this precious child,” as Leonard Bailey put it—is to value the lives of all. A rescue mission need not succeed to be brave.”


Baboon Heart Transplant For Baby Fae

Baby Fae shortly after transplant (Source: Commons Wikimedia)

JAKARTA - On October 26, 1984, a doctor named Leonard Bailey transplanted a baboon's heart into a baby named Stephanie Fae Beauclair. The public calls the baby Baby Fae. How did Fae have a baboon's heart?

Fae managed to live 21 days after the transplant surgery, two weeks longer than anyone who had a previous simian heart transplant. In Barstow, California, Fae was born three weeks prematurely with hypoplastic left heart syndrome.

This condition is a fatal defect, in which the left side of the heart does not develop. Usually babies with this condition are estimated to only live about two weeks. In fact, Fae's mother was given the choice to let Fae die in the hospital or at home. However Doctor Bailey had other options in mind.

Apart from his heart, Fae is in good health. The transplant will solve the problem. Still, baboon heart transplant is a taboo subject, even though transplant operations have been performed since 1967.

Bailey, who is a pediatric cardiac surgeon at Loma Linda University Medical Center in California, spent seven years researching xenografts or transplants from other species. Bailey's research includes more than 150 transplants in sheep, goats and baboons, many of which are interspecies.

The first interassimian and human transplant was performed in 1964. The transplant was successful, but the patient died a few hours after surgery. After that a similar transplant was performed only a few times. However, Bailey got permission to perform such a transplant on Fae.

When 12-day-old Fae's condition began to deteriorate on October 26, 1984, the medical team selected the baboon's heart and began transplant surgery. At 11:35 p.m. local time, "Fae's new heart began to beat spontaneously. It's really amazing," recalls Sandra Nehlsen-Cannarella, a transplant immunologist who worked with Fae.

Three other humans who received animal heart transplants - most recently in 1977 - failed. None of them lasted more than three and a half days. Bailey thinks babies with underdeveloped immune systems are less likely to reject foreign tissue than adults.

Fae's video was then shown on television and became a media sensation. Hundreds of people sent small greeting cards, flowers and money. Others expressed concern about the choice of baboons as donors.

Although Fae initially showed steady progress, her condition began to deteriorate 14 days after the transplant. Fae then died on November 16, 1984. Bailey then performed the first successful baby heart transplant the next one, in 1985.

After Fae's death, TIME wrote, “So, put an end to this amazing experiment that has caught the world's attention and made medical history. For three weeks a baby weighing 5 pounds (about 2.3 kilograms) has been surviving a baboon heart. two weeks longer than the previous animal's heart recipient. "


BABY FAE DIES, BUT DOCTOR SEES GAIN FOR SCIENCE

Baby Fae died Thursday night, but her doctor said today that the operation in which she received a baboon's heart had advanced science and one day would save the lives of many children.

The infant apparently died of complications that developed when her body rejected the transplanted heart.

Dr. Leonard L. Bailey, the surgeon who performed the transplant operation, said at a news conference that he would attempt another baboon-to- human heart transplant.

'𧮫y Fae has opened new vistas for all, including the as-yet unborn infants with lethal heart diseases,'' he said.

Parents Offered ɺ Ray of Hope'

Dr. Bailey thanked Baby Fae's parents for offering 'ɺ ray of hope for the babies to come.'' He said her family felt ''the surgery was worth it'' and told him ''not to let this opportunity be wasted.''

'⟊rry it on,'' were the mother's last words to him, Dr. Bailey said.

He also said he doubted that Baby Fae suffered pain in the 20-day period following the transplant operation.

When Loma Linda pathologists removed the walnut-sized baboon heart at an autopsy today, it was inflamed, a sign of rejection. But a final diagnosis will not be possible until a thorough analysis is made of the mounds of scientific data collected in the experiment.

Meanwhile, Dr. Bailey said he did not yet know what cause of death he would enter on the baby's death certificate.

The immunologist on the transplant team, Dr. Sandra L. Nehlsen-Cannarella, speaking at the news conference, called the experiment a success because ''we have been able to transplant tissue from one species to another'' with a much milder reaction than the team had expected.

''It has shown us that it is definitely feasible,'' Dr. Nehlsen-Cannarella said. But, she added, ''we can define that it didn't work because we lost the patient.''

Dr. Nehlsen-Cannarella, who directs transplantation immunology at Montefiore Medical Center and the Hospital of Albert Einstein College of Medicine in the Bronx, said the team undertook the controversial experiment as a desperate therapeutic measure because ''we felt it was going to succeed.''

Earlier, Dr. Bailey called the baboon transplant operation he performed on Oct. 26 a highly experimental procedure. Baby Fae was 12 days old at the time. But today Dr. Nehlsen-Cannarella said it was not as experimental as some doctors have portrayed it.

Dr. Bailey said he planned do another baboon heart transplant 'ɻy and by.'' Loma Linda's Institutional Review Board has given Dr. Bailey approval to do a total of five baboon heart transplants.

The 41-year-old pediatric heart surgeon said he had no plans to apply the experimental technique to adults.

''That's a whole other arena,'' he said. But, he added, he was sure colleagues elsewhere would investigate this possibility. Death Came After Kidney Failure

Baby Fae's death came at 9 P.M. Thursday Pacific standard time after her kidneys deteriorated and she developed a lethal cardiac complication called complete heart block.

Complete heart block disrupts the electrical impulses that travel from the top to the bottom chambers of the heart to control its beat.

As a result, the bottom chambers of Baby Fae's transplanted heart began to beat independently of the upper chambers and her heart rate ranged from 75 to 100 beats per minute instead of the 140 to 160 rate at which it had been beating.

A transplanted heart tends to beat faster because the nerves that inhibit its action are severed in the process of the operation. Also, a baby's heart normally beats faster than an adult's.

Many people who have complete heart block are alive today because they wear heart pacemakers. But mechanical pacemakers are not ordinarily used in heart transplants and Dr. Bailey said he did not use a pacemaker in Baby Fae.

''There were good reasons why we didn't, both technical and otherwise,'' Dr. Bailey said. Death Came as a Shock

Although the infant's life was always in jeopardy, her death came as a shock to many people who had followed news accounts.

Hospital officials listed Baby Fae's condition as only ''serious'' Thursday and said it was unchanged from the Wednesday, when Dr. David B. Hinshaw, a Loma Linda spokesman, said that Baby Fae seemed to be turning the corner in her battle against the rejection reaction.

Dr. Bailey, too, indicated that the medical team was surprised at the sudden turn of events Thursday night.

Throughout the experiment the medical team met each afternoon about 4 P. M. to discuss the infant's progress and laboratory test results and to plan therapeutic strategies.

Thursday's meeting 'ɾnded on an upbeat,'' Dr. Bailey said, although he also said he was deeply concerned about the management of her kidney problems.

For the three previous days she produced increasingly smaller amounts of urine although the creatinine test of her kidney function was normal. The test is a standard measure of kidney function. Only late Thursday did the tests begin to indicate serious kidney failure, he said.

But two hours after the meeting, ''things changed fast,'' as they can in a tiny infant, Dr. Bailey said. Results of Rejection Process

Although Baby Fae had developed a degree of heart failure earlier this week, Dr. Bailey said she lost heart function only in the last two hours of life. That loss, he said, was from a culmination of events surrounding the rejection process.

Dr. Bailey said his team struggled to the very end to save Baby Fae's life. Thursday night they used a form of artificial kidney therapy known as peritoneal dialysis to rid her body of the wastes that her kidneys could not excrete.

About 9 P.M., when her heart stopped, Dr. Bailey's team tried to start it again with closed cardiac massage. The effort failed.

Baby Fae's rapid demise followed a rejection epsiode that began about one week ago.

There had been unconfirmed reports that Baby Fae had experienced more than one rejection episode. But today both Dr. Bailey and Dr. Nehlsen-Cannarella said that she had experienced only one.

In the process, Dr. Bailey said, the infant developed kidney failure, which was a particularly difficult problem to treat in a five pound baby.

Nevertheless, he said the condition did not become ''lethal'' until Thursday night. Even then, Dr. Bailey said, he still hoped that Baby Fae's life could be saved because he had seen other babies with similar kidney and other problems survive such experiences and go on to lead normal lives.

Earlier, Dr. Bailey and Dr. Nehlsen- Cannarella said today, they believed the infant had turned the corner in her battle against the rejection reaction. In the bulletin issued at the time of her death, the doctors said her immunologic tests ''had not changed significantly.''

Dr. Bailey said the team would study the possibility that the kidney problems were related to cyclosporin-A, a drug used to combat rejection, or by antibiotic and other drugs that the baby received.

But for the moment, he said, he strongly suspected the kidney failure was due to a combination of factors.

Dr. Bailey said that Baby Fae, in her terminal stages, would not have been a suitable candidate for another heart transplant. He also said he did not consider a kidney transplant, which, though possible, would have been extremely difficult. Team Has Learned Much

Each day the Loma Linda team did several immunological tests as part of its research on the baby's response to the baboon heart.

Dr. Bailey said that his team had learned an enormous amount and that some things were 'ɻrand new to us.''

Dr. Nehlsen-Cannarella said that only in retrospect would the team be able to take a fresh look at the data the team had collected and to ''point out the road signs'' to determine what they had learned in the Baby Fae case.

Dr. Nehlsen-Cannarella said it was often difficult for the team to sift through all the data each day to make medical decisions during Baby Fae's lifetime. 'ɾvery time we made a decision there was more than one way to go,'' Dr. Nehlsen-Cannarella said.

Still the doctors spoke of several things they had learned.

One was that the baboon heart transplant acted very much like an ordinary human heart transplant. ''There was an astounding similarity between these two species when measuring them immunologically,'' Dr. Nehlsen-Cannarella said.

Another contribution cited by Dr. Bailey was his belief that in the future the Loma Linda team could diagnose rejection reaction earlier than previously possible.

However, the doctors declined to cite specific medical data until they had published their findings in scientific journals.

''We should not today dissect Baby Fae, but rather grieve passionately and, ironically, cheer just as passionately,'' Dr. Bailey said.

''Let this continue to be a uniquely human experience,'' he added.

Dr. Bailey said that much of what his team learned from Baby Fae's case would apply to the next baboon heart transplant, whenever it is done.

The surgeon said the experience had led him and his family to re-examine their lives. ''It was a very encouraging thing for me both in human and scientific terms,'' he said.

Throughout the Baby Fae case there were times when reporters were critical of the Loma Linda team for misstatements and lack of information. Today, Dr. Bailey complimented news organizations that had been critical and said he would reflect on some of the points they raised.

A memorial service for Baby Fae will be held at 4 P.M. Saturday on the Loma Linda University campus. Dr. Bailey said her parents would probably speak out about their experience in the near future. ''I think you'll find it very impressive,'' Dr. Bailey said.

In the end, he added, ''no doubt there has been a tremendous victory accompanying this loss, and you'll understand more about that when the data is public.''


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