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Experts Say Pig Liver Transplant Apparently Was World’s First After All

October 15, 1992

LOS ANGELES (AP) _ The recent transplant of a pig’s liver into a dying woman apparently was the world’s first such operation, and confusion over that claim was a matter of semantics, two experts said Wednesday.

In the latest case, a pig’s liver actually was implanted inside the patient’s abdomen.

In two earlier operations performed in Belgium, pig livers were surgically attached to blood vessels but weren’t actually implanted. Instead, the pig livers remained on the patients’ groins for several hours.

The animal organs performed the same job in both kinds of operation: to temporarily remove toxins from the bloodstream when the patients’ own livers were unable to do so.

Cedars-Sinai Medical Center in Los Angeles had said Monday that Dr. Leonard Makowka performed the world’s first pig-to-human liver transplant Sunday on 26-year-old Susan Fowler of Burbank, Calif. The implant - attached to Ms. Fowler’s own liver - was meant as a temporary lifesaving measure, but she died Monday night just before she was to receive a donated human liver.

″I will be absolutely amazed if it’s not truly a first,″ said Dr. Hugh Auchincloss Jr., a transplant surgeon at Massachusetts General Hospital and Harvard Medical School.

″The medical literature is vast, but given that fact, I do not believe there has been an actual pig-to-human liver transplant″ before the one performed by Makowka, said Dr. Fritz Bach, director of the Harvard Medical School’s Sandoz Center for Immunobiology.

Cedars-Sinai’s claim of a medical first had been challenged Tuesday by Dr. Gustavo G.R. Kuster, senior consultant on general surgery at Scripps Clinic and Research Foundation. He said two pig-to-human transplants were performed by Dr. D. Galmarini in Belgium in 1972 and were cited in a 1976 book he edited.

During another interview Wednesday, Kuster said the pig livers weren’t actually implanted, but were attached to the femoral blood vessels near the groin. The livers sat on the two patients’ groins for several hours, covered by a damp cloth, he said. One patient recovered from her liver ailment and survived. The other patient died.

″That is a transplant when you sew them (the liver and blood vessels) together,″ Kuster said, noting that a medical journal article on the operations referred to them as ″temporary auxiliary liver transplantation.″

Bach, however, said the procedure described by Kuster ″is not called a transplant.″

Kuster acknowledged that the operation at Cedars-Sinai ″is the first time they put the liver inside the abdomen.″

Pig livers also have been used to help humans during a third kind of procedure, which Auchincloss said has been performed 50 to 60 times. In that procedure - performed recently in Baltimore - catheters are placed in blood vessels in the leg, the blood is routed through a pig liver suspended in a bag of fluid, then the blood is returned to the patient’s body.

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