Download October 14, 1984 (approximate date):

On October 14, 1984, “Baby Fae” was born at Barstow Memorial Hospital. She
was born three weeks premature and only weighed five pounds. Being
unnaturally pale, doctors transferred her to Loma Linda Hospital where she was
diagnosed with hypoplastic left heart syndrome, which is usually fatal within two
weeks without an expensive procedure or a heart transplant. A day after she was
admitted, her mother received a phone call from Dr. Leonard Bailey suggesting a
xenografts – a heart transplant from a baboon to Baby Fae – in order to save her
life. Baby Fae was readmitted, and after many tests to supposedly find a viable
heart. She was given a heart transplant from a healthy baboon named Goobers.
The operation was a success, at least for a while. For weeks after, the press
covered the miraculous recovery of Baby Fae, and showed her talking on the
phone to her mother. She turned from a sick infant into a brilliant, pink, giggling
infant. The press barely covered the protests of animal rights activists outside of
the hospital. However, on November 15, the new heart failed when it became
entirely blocked, and Baby Fae also suffered renal failure. This was finally
determined to be because of a failure to match the blood type of the heart to Baby
Fae. Amazingly, the extensive tests run on both Baby Fae and Goobers failed to
find this out. (Pence 340-342).
“Xenotransplantation, as defined by the Public Health Service (PHS), includes
any procedure that involves the transplantation, implantation, or infusion into a human
recipient of either (a) live cells, tissues, or organs from a nonhuman animal source or (b)
human body fluids, cells, tissues, or organs that have had ex vivo contact with live
nonhuman animal cells, tissues, or organs” (Report 8 of the Council on Scientific Affairs
1). The earliest attempts to graft animal parts to people date back to the 17th century,
when a dog bone was used to repair the skull or a Russian Aristocrat (Klotzko 1).
Between 1990 and 1995, approximately 4,835 people a year donated organs after death,
but 48,000 people are on the waiting lists for such organs. 3,000 people each year die
because they are waiting for donor organs that simply do not exist (FDA Fact Sheet).
Furthermore, no good way of reproducing or cloning human organs is in sight. At the
mention of cloning a human body simply to harvest it’s organs, most ethicists are up in
arms. For these reasons, xenotransplantation is looking more and more viable.
Xenografts and transplants would provide a method of saving humans lives. However,
there are many non-publicized downfalls to these operations, which make them not as
viable as they may seem.
The FDA, in their background sheet on xenotransplantation, outlines many of the
risks of this procedure, as well as ways with dealing with them. The FDA has already
approved many of these operations – without adhering to the guidelines since they are
still in draft form. Dr. Luis H. Toledo-Pereyra of Michigan State University states,
“While research continues lives are being lost. The possibility of saving lives with
xenografts now is too great to wait for official guidelines or approval.” These mentioned
guidelines include protocol reviews, toxicity, virus, and bacteria screening of the donor
tissue or organ, and an absolute requirement of a skilled veterinarian and veterinary
anesthesiologist to ensure that the animal being used feels no pain. Also under these draft
guidelines, xenografts are only permitted in cases where animal transplants are one of the
only beneficiary choices for human survival. They can be used as “bridge transplants”
for people with failing organs on waiting lists, or as new treatments for older diseases that
may have promising results. However, although pig heart valve replacements in humans
have become nearly routine, and porcine neural cells may be a cure for Parkinson disease,
and some other tissues have been implanted with some success, the research that has been
continuing in this field provides little hope that these organs will be a true solution to the
organ shortage anywhere in the near future (Friedrich 287).
The long waiting lists that exist for donor organs seem puzzling. Less than 20
percent of American adults sign forms agreeing to be organ donors. The reasons for this
are many. Young adults often do not think about death and may not even give serious
thought at all to signing a donor card. Relatives may want to resist the idea of
“desecrating” a corpse by removing organs from it. Minority groups are reluctant to sign
these cards because they are afraid of being declared dead prematurely. Linked to this is
the confusion about what the term “brain dead” means. Surgeons do not take organs
from a patient if the family refuses. While this lowers the number of lawsuits, it also
lowers the number of donors. Other people seem to feel that a transplant team and their
sick one’s doctor are working at odds with one another. Both are working to save their
patients, but they are still working to save different patients (Pence 321-322). In a lot of
these cases a donor organ from an animal may be an attractive choice. Who should die:
the human or the animal? To families, the choice is clear: their loved one is much more
important than an animal they have never seen, touched, or met. Yet, animal rights
activists and some ethicists claim that no animal should have to give their life for a
human, especially when they are non-autonomous. Humans cannot donate organs unless
they are fully autonomous and making the decision for themselves. Since animals are
incapable of this they should also be incapable of being donors. Besides, there are other
options. “Living donors” are becoming more and more popular. These generally are
relatives of a patient that agree to give a lobe of their lung, liver, or other organ to a dying
relative. These operations are usually widely successful on the receiving end. 75% are
alive after the first year. In contrast, only a few recipients of xenotransplants have lived
more than a month. This choice also seems clear: a human organ will provide better
results in almost all cases (Pence 335, 356). If the public in general were more educated
about the need for organ donation, and also were educated about the reality and definition
of brain death and all of the regulations surrounding it, more would probably become
donors. Some people believe that increasing funding for public education of these issues
would create more successful donations and operations than furthering the study of
xenografts (Klotzko 3).
Xenografts and transplants are dangerous because they expose the patient to
bacteria and viruses that are dormant in animals but deadly to humans. “Zoonosis is
defined by the PHS as a disease of animals that may be transmitted to humans under
natural conditions” (Report 8 of the Council on Scientific Affairs 3). Some such diseases
include Ebola, Hanta virus, and influenza. Transplantation of any kind can transmit
infections. On top of this transfer, post surgery medications like Cyclosporin are given to
stop the immune system from rejecting the foreign tissue in the body. However, this also
stops the immune system from reacting to any diseases inserted into the body by the new
organ. Xenografts between humans and primates may have a high likelihood of success.
However, pathogens that do not harm the host species could be deadly to humans if
injected, like the SIV virus (which is the simian variation of the HIV virus in humans)
(Report 8 of the Council of Scientific Affairs 5). There is also fear that new diseases may
be introduced into these patients, and then spread out to the general public through
contagion. It is also possible that AIDS and HIV in humans was first introduced when
simian blood was injected into humans. If this is true, are the risks of xenotransplants
really worth the gains?
Probably not. Almost all recipients of xenotransplants have died because of
bacterium or viruses that are dormant in animals but deadly to humans (Pence 347). The
other recipients died because of failure in other organs, or from failure to match crossspecies blood type (as in the case of Baby Fae.) These are all very serious risks that
suggest that more human donors need to be found, rather than researching with animals.
PETA, People for the Ethical Treatment of Animals, have quite a bit to say
against xenotransplantation on their website. However, some of their data is completely
justifiable by the FDA report. For example, according to the FDA report, animals to be
used in xenotransplants or grafts must be raised in seclusion and in environments that will
minimize infection in the animal. PETA states that these “sterile environments” are
really very small boxes (not even cages, since this would allow air other than what is
pumped in) without windows and with special tubes that the monkey or other animal
must learn to suck in order to receive water and nourishment. This inhumane treatment
of animals being used to save humans seems most unfair, especially on top of the success
rate of these surgeries and the possibility of infection from naturally occurring agents in
animals anyway.
Xenografts are ultimately not the answer for our organ shortage. While they may
seem attractive to some, they are not an immediate answer to the problem our country
and the world has in saving lives. In the future, there may be better procedures for
cleansing these organs of all but human agents, and for guaranteeing a higher success
rate, but for now these are simply goals set far into the future. Xenotransplants are at best
a very new technology that are being used as almost an old one – although the procedure
between transplanting a human or animal organ is nearly the same, the differences
outlined in this paper still remain. Xenografts are of questionable safety and ethnicity.
Let us look to our own species for our salvation.
Bibliography and Works Cited
Blum, Deborah. The Monkey Wars. Oxford University Press, New York. 1994.
“Fact Sheet on Xenotransplantation.” FDA Backgrounds. September 20, 1996.
20 April 2001 <http://www.fda.gov/opacom/backgrounders/xeno.html>.
Friedrich, M. J. “Fetal Pig Neural Cells for Parkinson Disease.” JAMA, 274 (1995):
285-288.
Klotzko, Judith. “Technology and Business: Pork Progress.” Scientific American
November, 1999.
“Leonard Bailey, World-Renowned Heart Surgeon, Remembers With Fondness A
Tiny Baby Named Fae.” Children’s Health. 1999. (30 March 2001).
<http://hcvn.com/who'sbabyfae/>.
Loma Linda University. “Anencephalic Infant Donor Protocol.” 2001. (April 1, 2001)
< http://www.llu.edu/info/legacy/Legacy5.html>.
Toledo-Pereyra, Luis H. MD, PhD. “Xeno: The Promise of Transplanting Animal
Organs into Humans.” Michigan State University. November 2000.
Pence, Gregory E. “Infants and Medical Research: Baby Fae and Baby Theresa.”
Classic Cases in Medical Ethics. Madison, WI. McGraw Hill, 2000. 340-360.
“PETA – People for the Ethical Treatment of Animals.” 2001. (April 8, 2001)
< http://www.peta.org/> .
“Report 8 of the Council on Scientific Affairs (I00) Full Text.” American Medical
Association. December 2000.
< http://www.ama-assn.org/ama/pub/print/article/2036-3606.html>