Doctors · Medical · Surgery · United States

November 15, 1984 – Baby Fae Dies

I remember this story when I was younger. I would have been in the eighth grade at the time. I remember hearing on the news how tragic and miraculous of a story it was.

As I was thinking about this story, and wondering if I should cover it today, I started thinking about the benefits of Baby Fae’s surgery and death.

Are there any?

Was it worth it?

Was this little girl dead already, and Dr. Bailey was trying to save her life?

This one might be an odd article and I am feeling heartache as I write it.

If you are willing to keep reading, I am not certain where this will lead.

So, down the rabbit hole we go!

Facts

On October 14, 1984, Stephanie Fae Beauclair –named Baby Fae to hide her identity– was born 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.

Baby Fae
Baby Fae
Image Source: snipview.com

Dr. Leonard L. Bailey, a Cardiothoracic  surgeon from Loma Linda University, had spent almost a decade trying to prove that you could do cross-species transplants (Xenotransplantation).

Dr. Bailey convinced Baby Fae’s mother to allow him to do a baboon-to-human heart transplant in an attempt to save her life. There had been three other humans that received animal-heart transplants. None of the previous had lived longer than three days. Dr. Bailey was convinced that Baby Fae’s immature immune system would adapt and accept the baboon heart as her own.

On October 26, 1984 Dr. Bailey preformed the first ever baboon-to-human heart transplant, replacing Baby Fae’s damaged heart with that of a young baboon.

Baby Fae survived the operation and she became an international celebrity as the world held their breath and watched on.

Baby Fae held on for 20 days, longer than any other human animal donor. Her tiny little body fought a constant battle to reject the invader in her chest. Dr. Bailey and his team fought a constant battle to force her body to accept the new heart by increasing the amount of immuno-suppressive drugs.

In the end, the drugs that were meant to help her caused her kidneys to fail, and Baby Fae lost her fight.

Controversy

Here is where I hit a wall that I was not expecting.

1) Baby Fae’s mother was told that her daughter’s condition was fatal, and there was no other recourse but to attempt this xenograft (grafting in of a foreign object), The team did not look for another organ donor, as Dr. Bailey wanted to preform this surgery that some doctors call an experiment.

At Children’s Hospital in Boston, MA, Dr. William Norwood had been repairing Hypoplastic left-heart syndrome since 1979 with a 75% success rate.

So, there were other avenues to explore that to replace her heart with that of a baboon.

2) In the seven years leading up to Baby Fae’s heart transplant, Dr. Bailey had preformed 160 cross-species transplant surgeries on sheep and goats. None of the animal test subjects lived longer than six months.

Dr. Bailey was advised that his trials were not ready for human testing yet. – Mathews J: Colleague warned doctor before Baby Fae implant. Washington Post, 1984.

3) Baby Fae was not the first human to receive a primate organ transplant. The Council of Scientific Affairs of the American Medical Association noted a rapid rejection of all baboon transplants to humans.

Dr. Bailey was certain that the infant’s immature immune system would be different.

Immunologists from around the world said that there was no way that it could have worked. Baboons do not have the same antigens in common with humans.

Additionally, they said that the same part of the immune system that would reject a transplant is fully mature at birth.

4) Dr. Bailey’s use of baboons surprised quite a few people in the medical and scientific community as baboons are very distant  from other primates compared to humans when it comes to evolution.

When giving an interview with an Australian radio show, they were forbidden from asking direct questions about the operation. The reporters asked Bailey asked about why he chose a baboon as they are so far from humans on the evolutionary chain. Dr. Bailey said “Er, I find that difficult to answer. You see, I don’t believe in evolution.”

5) When surgeons want to do difficult and experimental procedures, there are oversight committees in place to govern these things. Some would say that the Loma Linda Medical Center’s review board had a lapse of judgment and failed Baby Fae. Highly experimental procedures like those preformed on Baby Fae would have required permission from the United States Secretary of Health and Human Services.

Because Bailey did not look for a human heart donor and did not refer Baby Fae elsewhere for attempted surgical repair, the highly experimental transplant was both unethical and unlawful…..The facts, however, suggest that Baby Fae was sacrificed to Leonard Bailey’s career. Given the state of current medical knowledge, there was no doubt that Baby Fae would reject the baboon heart. Rules and laws designed to protect her were violated by those entrusted to uphold them. Professional ethics were considered to be of less importance than widespread publicity. The institutional review boards and law enforcement agencies responsible for protecting human subjects have virtually no accountability to the public, much less to the experimental subjects themselves.

Perspectives On Medical Research – Volume 2, 1990 – Baby Fae:The Unlearned Lesson – Kenneth P. Stoller , MD.

Conclusions

I am not certain what the answers to my questions are. There are issues in the medical community on how best to deal with this issue even 31 years later.

I do know that the surgery helped Dr. Bailey learn to do heart transplants, and on November 20, 1985 Baby Moses became the youngest heart transplant recipient at four days old. And in January 1986, 17-day-old Baby Eve became the second oldest heart transplant recipient.

Loma Linda University Medical Center considers all of this a success.

Sources and additional reading

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s