The gift of life - infant heart transplants; includes interview with Leonard Bailey

Vibrant Life, Sept-Oct, 1990 by Waldena J. Gaede

The Gift of Life

Miracle. It's a word one doesn't expect to come across routinely. Yet the word miracle keeps coming up again and again--in a reporter's story, in a parent's narrative, in a professional's assessment.

Denise Maloof, a staff writer for the Gwinnett Daily News of Lawrenceville, Georgia, began her February 7, 1989, report: "The infant transplant team of Loma Linda University's Medical Center deals almost daily in miracles. And currently team members are surrounded by 28 living miracles who visit either weekly, monthly, or yearly for preventive checkups. Some of these squealing miracles are still young enough to travel in their parents' arms."

"It's the miracle we've been waiting for," said Mario Stork, father of an infant about to receive a transplant on February 28, 1988, at Loma Linda.

Lawney and Christina Falloon are the parents of Krysta, born with hypoplastic left-heart syndrome on December 9, 1988. Krysta received a new heart on December 29, when only 20 days old. "This has meant an incredible amount to us," says Mr. Falloon. "You start to take life for granted. When something like this happens, it jolts you into reality and you realize how easily life can be lost. We and our daughter have been given a second chance, and we'll always be grateful for what Dr. Bailey has done for us. He performed a miracle; it's that simple. If this had happened just three years ago, Krysta would have died."

Between 2,000 and 3,000 babies are born in North America each year with incurable heart disease. Of these, between 20 and 30 percent are born with hypoplastic left-heart syndrome, a defect in which the left side of the heart, which pumps blood through the body, is underdeveloped. There is no cure. Traditionally, parents have been told to take their infant home to die.

Until Dr. Bailey. Until Baby Fae.

On October 26, 1984, Leonard L. Bailey, M.D., professor of surgery and chief of cardiothoracic surgery, sewed the heart of a baboon into the chest of a dying baby girl called Baby Fae. For 21 days the procedure worked--until Baby Fae's kidneys failed, and she died. However, Baby Fae did not die in vain. Her legacy is the gift of life for all those who have followed.

What the team learned from Baby Fae gave them courage to continue their fight to save these dying infants. She had not rejected the heart, as many had predicted. She also died a much more peaceful death than she would have, if she had not had the operation.

Perhaps the most lasting contribution of Baby Fae was public awareness--awareness of the need for donor hearts, awareness of the alternative to certain death offered by infant heart transplant surgery.

A year after Baby Fae's historic operation the team performed the first human-to-human transplant in a newborn, 4-day-old Eddie Anguiano, who was known as Baby Moses. Eddie is the longest-surviving infant to receive a heart transplant. He will be 5 years old this November.

The next milestone in the infant heart transplant program came on October 16, 1987, when Paul Holc, a Canadian infant just 3 hours old, received a heart. He became the youngest person ever to receive an organ transplant of any kind.

His condition was diagnosed at nine weeks before birth, and he was put on the list to receive a heart. When a donor heart was located, Baby Paul was delivered by cesarean section and received his new heart three hours later. The donor had been an anencephalic infant.

Anencephaly, an incurable defect in which most of the brain and skull are missing, occurs in about one of every 1,500 to 2,000 live births. It can be detected through testing early in pregnancy. Some parents choose to end the pregnancy, but others decide to allow the child to be born.

Most anencephalic infants are still-born or die within hours or days. All die soon--95 percent within the first week after birth.

On Sunday, August 20, 1989, another milestone was reached when Steven R. Gundry, M.D., associate professor of surgery, successfully transplanted a new heart into 20-day-old Katherine Lehto, the 50th young infant to receive a human heart at Loma Linda.

Since January 1988, the survival rate has been a phenomenal 95 percent. Nearly all the survivors have done well so far, with normal growth and development.

Miracle indeed.

The following is a portion of an interview vieh Dr. Leonard Bailey by the editors of Loma Linda University Scope: However does the public's awareness of infant heart transplants help solve the problem of donor supply?

We need a steady reminder that children who need organs are dying every day, and there are children dying every day who have health organs to give. It is a terrible waste and tragedy.

We are generating a growing interest on the part of people to donate infant organs.

On the surface, infant heart transplantation sounds like far-out treatment. In reality, it is one of the most conservative things you can do for a baby with incurable heart disease. You can use all sorts of other radical procedures to get them to age 4 or 5, and then watch them die. But transplantation is a truly conservative approach. To get others to believe that is a matter of education.