Medicine: Baby Fae Loses Her Battle

The baboon heart fails, but a doctor defends the transplant

After 21 days of battling to preserve a fragile life, Dr. Leonard Bailey was visibly spent. His voice trembled and broke with emotion last Friday as he faced the press at Loma Linda University Medical Center in California to provide the epitaph for the dark-haired infant known as Baby Fae. "Today we grieve the loss of this patient's life," said the 41-year-old heart surgeon. That life, he insisted, had not been in vain. "Infants with heart disease yet to be born will some day soon have the opportunity to live, thanks to the courage of this infant and her parents. We are remarkably encouraged by what we have learned from Baby Fae." So ended an extraordinary experiment that had captured the attention of the world and made medical history. For three weeks the 5-lb. infant had survived with the heart of a baboon—more than two weeks longer than any previous recipient of an animal heart. (Read "The Using of Baby Fae.")

Her brief life was marked by more than its share of controversy. Doctors challenged the wisdom of using an animal heart when a human organ might have been preferable; animal lovers protested the sacrifice of a healthy monkey for what they saw as medical sensationalism; and others questioned the circumstances under which Fae's parents had consented to so drastic a procedure. Nonetheless, Fae's struggle for survival converted many skeptics and won the hearts of millions of people. Her progress and setbacks—virtually every beat of her simian heart—were avidly followed. Hundreds of Americans sent cards, flowers, even money to the infant as gestures of support and sympathy.

Though no one expected Fae's survival to be easy, her death last Thursday night came as a surprise. The child, who was born with a fatal defect called hypoplastic left heart, had received the heart of a seven-month-old female baboon on Oct. 26 and made steady progress for the next two weeks. In a touching videotape made just four days after surgery, Baby Fae was seen yawning and stretching, seemingly a normal infant in every respect. By the second week she was no longer dependent on a supplementary oxygen supply or intravenous feeding. (Read "Baby Fae Stuns the World.")

According to her doctors, problems did not arise until the 14th day after surgery, when a battery of tests revealed that the infant's body was beginning to reject the alien heart. Over the next five days, doctors increased her dosages of the antirejection drugs, supplemented her weakening heart with digitalis, eased the strain on her breathing with a respirator and resumed intravenous feeding. By Wednesday of last week Surgeon David Hinshaw told a packed auditorium of reporters at Loma Linda that "she is in the process of turning around. Signs of rejection are reversing right down the line. Baby Fae is holding her own."

As late as 7 p.m. Pacific time on Thursday, just two hours before she died, a hospital spokesman was reporting that the child was "hanging in there." In fact, Baby Fae was experiencing kidney failure. For several days, the child's urine output had been declining—an indication that the kidneys were not functioning properly. This put other organs in jeopardy and ultimately contributed to heart failure, Bailey explained at the press conference. It was not clear if Fae's kidney problem was due to her drug regimen, the surgery or rejection, which can trigger the failure of a number of organs. Most likely, it was a combination of factors. Though doctors had discussed the possibility of a second transplant—either from a human donor or another baboon—the child's weakened condition made this impossible. At 10:30 p.m. the hospital released a tersely worded death announcement: despite "intensive efforts" to restore her heart, "Baby Fae died at 9 p.m. Her parents were with her as much as possible during this period and are receiving support from chaplains and the physicians."

See the top 10 medical breakthroughs of 2008.

See TIME's covers about babies.