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Pioneer In Infant Heart Transplants Undefeated By Nicky’s Death

July 3, 1986

LOMA LINDA, Calif. (AP) _ The surgeon who pioneered experimental heart transplants in infants says he doesn’t feel defeated despite the death of Baby Nicky, a Texas toddler who received two implanted hearts in two days.

″Every mountain has at least two valleys, and I suppose you’d have to think of this as one of the valleys in the heart transplant business,″ Dr. Leonard Bailey said Wednesday after 3-year-old Nicky Carrizales died at Loma Linda University Medical Center.

Bailey said an autopsy should reveal the cause of death. But he added that Nicky’s internal organs were badly swollen with fluid from 18 hours on a heart-lung machine between his two transplants on June 17-19, and lung failure that started Tuesday ″was the straw that broke the camel’s back.″

An infection was the prime suspect as the cause of Nicky’s lung failure, Bailey said. The boy’s parents, Rudy and Mary Lou Carrizales of San Antonio, were at his bedside as his condition deteriorated.

There was no sign that Nicky’s immune system rejected the heart, said Sandra Nehlsen-Cannarella, chief of immunology.

Despite sadness about the child’s death, ″I sense no defeat from this experience,″ Bailey said.

Nicky, born with multiple heart defects, had been in critical condition ever since his transplants, and received dialysis for acute kidney failure and to reduce the swelling of other organs.

After Nicky’s first transplanted heart failed, Loma Linda appealed urgently for a second donor. The donor was a 6-year-old Aurora, Colo., boy shot to death by a playmate.

Nicky was the sixth and oldest chilon whom Bailey has performed such surgery since November.

The other five - known as babies Moses, Eve, James, Rachel and Jesse - remain alive.

Rachel, still fighting her body’s attempt to reject her new heart, remains hospitalized, as does Jesse Dean Sepulveda, who should be discharged next week after combatting a recent, mild rejection episode, Bailey said. Eve, James and Moses were at home and doing fine.

Bailey stirred controversy when he implanted a baboon’s heart in a girl known as Baby Fae in October 1984. She died 20 1/2 days later.

Heart transplants still are considered experimental in infants. The Nov. 20 infant-to-infant heart transplant on Baby Moses was only the third such surgery ever performed. Two earlier efforts - in New York in 1967 and London in 1984 - ended in the deaths of the newborn recipients.

Bailey said Nicky’s death indicated ″kids beyond the newborn are a different ballgame″ when it comes to heart transplants because their immune systems are more mature, making rejection more likely, and because their heart defects have more time to harm other organs.

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