Monday Nov 12 1984 Baby Fae Stuns the World By Claudia Wallis A baboon heart transplant inspires both awe and anger Except for the gauze covered wound stretching almost the length of her torso the tiny dark haired baby girl might have been just any infant Lying in her crib with a pacifier close at hand she gave a couple of gaping yawns She delicately stretched her scrawny arms in weariness And mostly she slept But last week as television viewers got their first glimpse of the newborn known only as Baby Fae it was her visibly heaving chest that stole the show There was no mistaking the pulsations of life and no forgetting that the power source was the freshly implanted heart of a young baboon One week after the historic transplant operation at Loma Linda University Medical Center in Southern California the first infant though not the first person to receive a simian heart was reported to be doing remarkably well All vital signs are still good and there s no sign of rejection said Hospital Spokeswoman Patti Gentry noting that Baby Fae was just gulping down her formula Outside the hospital there was wonder and excitement over this latest medical marvel but the enthusiasm was dampened somewhat by controversy Antivivisectionists around the country and abroad protested what they called ghoulish tinkering with human and animal life This is medical sensationalism at the expense of Baby Fae her family and the baboon charged Lucy Shelton of People for the Ethical Treatment of Animals The group was one of several that demonstrated outside the Loma Linda hospital last week The medical community though normally receptive to technical innovation was sharply divided There has never been a successful cross species transplant declared University of Minnesota Surgeon John Najarian one of the country s leading pediatric transplant specialists To try it now is merely to prolong the dying process I think Baby Fae is going to reject her heart Others defended the experiment It s very easy to sit back and be negative when a new treatment is announced said Dr John Collins chief of cardiac surgery at Boston s Brigham and Women s Hospital If we all were afraid to attempt the untried we would have no new treatments Little is known about the 5 lb object of all this controversy or how she came to be the subject of so dramatic an experiment Loma Linda officials have refused to reveal the child s real name the identity of her parents or even her exact age They did say that she was about two weeks old at the time of surgery and had been born three weeks premature Baby Fae was referred to Loma Linda by a pediatrician in Barstow Calif The 546 bed facility is one of more than 60 U S hospitals operated by the Seventh day Adventist Church and has a fine reputation in pediatric heart surgery Fae was suffering from hypoplastic left heart syndrome a fatal condition said to affect one in 12 000 newborns In children with this defect the left side of the heart including its main pumping chamber the left ventricle and the aorta is seriously underdeveloped In Fae s case doc tors said the left side of the organ was virtually nonexistent Dr Leonard Bailey 41 the pediatric cardiac surgeon who treated Fae over the years had seen dozens of infants with this defect die generally within two weeks of birth While a transplant from a human donor could theoretically be used to help such babies Bailey was discouraged by the drastic shortage of infant hearts Seven years ago he began investigating the possibility of using hearts from other species or xenografts He performed more than 150 transplants in sheep goats and baboons many of them between species Last December after what Bailey called months of agonizing the Loma Linda institutional review board gave him preliminary approval to implant a baboon heart in a human infant The final go ahead came just two days before Baby Fae s surgery There is evidence that the chimpanzee orangutan or gorilla may be a better donor Bailey noted last week but they are either an endangered species or don t procreate well in captivity 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 sevenmonth 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