By Emily Langer / The Washington Post
Leonard Bailey, a pediatric surgeon who attracted international attention in 1984 when he transplanted a baboon’s heart into a newborn human — “Baby Fae” — a medical moon shot that sparked breathless controversy but was credited with demonstrating the lifesaving potential of organ transplants for the tiniest patients, died May 12 at his home in Redlands, California. He was 76.
His death was announced by Loma Linda University Health, the Seventh-day Adventist institution in California where he taught and practiced for more than four decades, including as surgeon in chief. The cause was neck and throat cancer, said his son Brooks Bailey.
The surgery that Bailey performed at Loma Linda University Medical Center on Oct. 26, 1984, entered the annals of medicine as one of the most ambitious undertakings in surgical history.
Baby Fae was the name used to preserve the privacy of the 12-day-old infant later identified as Stephanie Fae Beauclair. She suffered from hypoplastic left heart syndrome, a congenital defect in which the left side of the heart is fatally underdeveloped. A newborn heart is the size of a walnut, taxing the technical abilities of even the most able surgeon.
“In those days, the advice to parents was to leave the baby here to die or take it home to die,” Bailey recalled years later in an interview with his university.
Because of the shortage of infant organs available for transplant, Bailey had for years been investigating the possibility of using animal organs, a procedure known as xenografting.
He was not the first surgeon to perform a cross-species transplant; doctors had transplanted kidneys, a heart and a liver from chimpanzees in the 1960s. But when Bailey offered a baboon heart to Baby Fae’s parents, and when they accepted, he was the first surgeon to perform such an operation on an infant.
After the five-hour procedure, when the baboon heart began beating on its own, the mood was “somber, not euphoric, but there wasn’t a dry eye in the house,” Sandra Nehlsen-Cannarella, an immunologist who assisted with the operation, told The Associated Press at the time. “It was an overwhelming feeling of accomplishment and satisfaction, to see her literally transformed from a helpless cripple.”
Baby Fae lived for 21 days after the procedure – longer than any other recipient of such a transplant at the time – before she died from complications including kidney failure. Her blood type, incompatible with the baboon’s, was cited as a contributing factor in her death.
The surgery and Baby Fae’s death ignited fierce debate among physicians, medical ethicists, theologians and members of the public captivated by a story that seemed to be drawn from science fiction. Critics argued that he should have first sought a human heart for Baby Fae, although the chances of locating one were slim at best.
Some medical professionals considered the biological hurdles of xenografting too difficult to surmount, especially with the relatively limited immunosuppressive drugs available at the time. Other critics objected on religious grounds, suggesting that a cross-species transplant undercut the uniqueness of humanity. Still others objected to the sacrifice of an animal life to save a human one.
“We’re not in the business of uselessly sacrificing animals,” Bailey said. “But we’re forced to make a choice. We can either decide to continue to let these otherwise healthy human babies die because they are born with only half of their heart, or we can intervene, and, in so doing, sacrifice some lesser form than our own human species.”
Arthur Caplan, a bioethicist at the New York University School of Medicine, described the baboon transplant as a “landmark attempt” to keep a young patient alive until a human organ became available. He said in an interview that he disagreed with the experiment because of the enormous biological challenges it presented, but he described Bailey as a “remarkable surgeon” and a “person of very high moral character.”
“He was really trying to find an answer for very young children who needed a transplant,” Caplan said. “He was driven by a real desire to help … not fame, not fortune, not money, not greed.”
A year after the operation on Baby Fae, Bailey performed what has been described as the first successful transplant of a human heart to a newborn. The recipient, Eddie Anguiano, was known at the time as Baby Moses and suffered from hypoplastic left heart syndrome. He is alive today.
According to the university, Bailey performed 376 infant heart transplants over his career. “Many of his infant heart-transplant patients came back to visit him as teenagers and adults,” according to the university’s announcement of his death. “At least one went on to medical school.”
Leonard Lee Bailey, the son of a chef, was born in Takoma Park, Maryland, on Aug. 28, 1942. He received a bachelor’s degree in premedical studies in 1964 from what is now Washington Adventist University in Takoma Park before receiving a medical degree from Loma Linda University School of Medicine five years later.
Bailey was completing a residency in thoracic and cardiovascular surgery at the Hospital for Sick Children in Toronto when he began to consider the possibility of performing heart transplants on newborns. It was a radical idea, with scant support among his colleagues, but one that Bailey insisted on pursuing. He had lost 20 patients when his operations to repair their faulty hearts had failed.
His thought, he told Investor’s Business Daily in 1999, was, “What if these children could be given brand new hearts?”
Bailey’s wife of 52 years, the former Nancy Schroeder, accompanied him and his heart-care team in their international travels. She died in April. His survivors include their two sons, Connor Bailey and Brooks Bailey, both of Redlands; a sister; and two granddaughters.
According to Caplan, the “Baby Fae” operation led to modern research into organs from genetically engineered animals, particularly pigs, to contend with the small number of available organs for the large number of patients who need them.
“We wouldn’t be where we are if it weren’t for Baby Fae,” Bailey had told The New York Times in 1990. “We’re not as crazy as everyone believed. The experiment gave us the confidence to continue.”