Transplant Trials

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.