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Starzl Defends Chimp-To-Human Liver Transplants

January 11, 1985

PITTSBURGH (AP) _ Liver transplant pioneer Dr. Thomas E. Starzl, concerned about a serious shortage of donor organs for critically ill infants, says surgeons may have to rely on livers from chimpanzees to save the babies’ lives.

The University of Pittsburgh, ″under exceptional circumstances, has not absolutely ruled out the prospect,″ Starzl said.

″The options are, of course, greater public awareness that could produce appropriate donors of that very small size. Secondly, the possibility of artificial organ support for which we have no promise at this time. And the third thing is possible animal donors,″ he told reporters.

Dr. Thomas Detre, vice president for health services at the university, said he plans to appoint a six-member medical ethics panel within the next few weeks to consider chimpanzee-to-human liver transplants and other issues.

″My views are always that nothing should be excluded,″ Detre said. ″What we need to do is examine this question very carefully from a medical and ethical point of view. It is an important issue (reflective) of the complexity that our society will have to be facing in the coming years.″

Because of a severe shortage of donor livers for children under 6 months of age, many die while waiting for an organ, Starzl told medical students and hospital personnel during an ″Ethics for Lunch″ presentation.

Up to 90 children currently are awaiting livers at the University of Pittsburgh. Six or seven are under 6 months of age and have ″very little prospect″ of getting a liver, according to Starzl.

Their only hope for survival is to receive the liver of a chimpanzee, the closest match among animals, Starzl said.

″There’s quite a lot of evidence″ that chimpanzees are the best source among animals for donor livers, he said.

Twice during the 1960s, faced with a shortage of human donors, Starzl transplanted the livers of chimpanzees into critically ill youngsters at the University of Colorado. Both children died soon afterward due to infection.

Starzl said he approached Detre last October before the Baby Fae case to discuss the possibilities of chimpanzee-to-baby liver transplants.

The 12-day-old Baby Fae, who was suffering from a fatal heart defect, underwent the world’s first baboon-to-baby heart transplant last Oct. 26 at Loma Linda University Medical Center in California. The little girl, whose real name was never revealed, died Nov. 16.

Baby Fae’s transplant aroused controversy among doctors after it was revealed that Lomo Linda physicians had not tried to obtain a human infant heart, saying that such donors were rare. Critics also questioned whether Baby Fae’s parents had been adequately informed about alternative corrective surgery.

Starzl said the Baby Fae case dampened Pitt’s enthusiasm for a chimpanzee- to- baby liver transplant.

″It alerted us to the magnitude of all of these issues,″ he said.

Numerous problems surround chimpanzee-to-human transplants, according to Starzl.

Chimpanzees are an endangered species and cost about $10,000 apiece, Starzl said. In addition, the animals are highly intelligent.

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