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1993-04-08
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THE WEEK HEALTH & SCIENCE, Page 18Transplant Trials
The baboon liver did fine, it turns out. But the patient, now
dead, had the AIDS virus
For more than two months, the world's first baboon-to-human
liver transplant patient seemed to be improving. Doctors
successfully treated a mild case of tissue rejection a few weeks
after the ground-breaking 11-hour operation at the University
of Pittsburgh Medical Center. The problem did not recur, and by
the end of July the new liver had tripled in size, matching a
healthy human organ. But late last month a fever set in,
followed by an infection -- possibly caused by an injection of
X ray-sensitive dye. The liver began to fail, and then, within
a week, though the infection had started to subside, the man was
dead of massive bleeding in the brain.
The cause of the bleeding was not immediately known, but
doctors said it was probably not due to rejection -- which means
the Pittsburgh team may try a similar transplant as early as
the end of the year. The next time, the patient may be in
better overall health: the hepatitis B that destroyed this man's
own liver was just one of his medical problems.
Perhaps the most serious -- from an ethical, if not a
medical, point of view -- was that he was infected with HIV.
Hospital spokesmen explained that policy forbids transplants for
people with active AIDS but not for those who are merely
infected, and that he fit the criteria. But critics charged that
performing experimental surgery on someone who may have felt he
had little choice was inappropriate.