California doctors proceeded with an extraordinary baboon-to-baby heart transplant after indicating that they had no suitable alternative to save the child from certain death despite success by Philadelphia and Boston surgeons in treating more than 50 infants with similar heart defects.

Dr. Leonard L. Bailey, the head of a surgical team that performed the operation, said through a spokesman today that the possibility of other treatment "was explained very carefully" to the infant's parents but they opted for the transplant.

A statement issued by Bailey's university after the transplant appeared to be incomplete, however.

A news release distributed after the Friday morning transplant of a baboon's heart into a 14-day-old baby at the university medical center mentioned the work of Dr. William Norwood in Philadelphia. But the release said he had "limited success" correcting such defects and "other experienced infant heart surgeons have been unable to reproduce his results."

In a telephone interview from Philadelphia Childrens Hospital today, Norwood said that not only he but doctors at Boston Childrens Hospital have succeeded in helping children suffering from hypoplastic left heart syndrome, the condition that led to the baboon heart transplant for "Baby Fae" in Loma Linda.

He said about 40 of the 100 patients he has treated with a special two-step surgical procedure have survived. The oldest is now 4 years old, he said, and expected to lead a normal life, barring major exertions such as running a marathon. Dr. Aldo Castaneda of Boston Childrens Hospital said about 15 of his 30 most recent patients have survived.

Some experts on medical ethics have protested the use of an infant for an experimental procedure, and animal rights advocates have attacked the killing of a 7-month-old baboon for the operation. But Loma Linda University officials said the child would have died soon without the procedure, and a university ethics committee approved the operation as long as it had a chance of saving the infant. The day after the transplant, a hospital spokesman described the condition with which the baby was born as "100 percent fatal" if left untreated.

A spokesman for the medical center at the Seventh-Day Adventist university 60 miles east of Los Angeles where the transplant occurred said Baby Fae, the name used to protect the infant's identity, remained in stable condition today, with the transplanted heart performing normally. The condition of the infant, who was awake and apparently healthy, was upgraded from critical to serious late today, a hospital spokesman said.

Four previous human recipients of ape hearts in Mississippi, South Africa and Britain have survived no longer than a few days. Bailey, the head of the Loma Linda surgical team, said Sunday he once kept a goat alive with a lamb's heart for 165 days. He said he has performed nearly 150 heart transplants between animals in the last seven years and has reason to believe humans and apes may be more compatible than sheep and goats.

Given the possibility of fatal rejection of a transplant and possible harmful side effects from drugs to suppress rejection, Norwood, 43, chief of cardiac surgery at his hospital, said, "If I had my druthers I would rather use other options short of transplants." Castaneda, 54, chief of cardiac surgery at the Boston hospital and a former research partner of Norwood, said, "At least people ought to know that it is an alternative."

A spokesman for the Loma Linda University Medical Center said she did not know why the university press release erred in reporting the Norwood procedure.

At a news conference Sunday, Bailey cited a July 1983 report on Norwood's work, which he said indicated only two of 35 patients had survived the procedure.

Norwood said he could not evaluate whether the Baby Fae transplant was right or wrong without Baboon's Heart Seen as Not Sole Option for Baby By Jay Mathews Washington Post Staff Writer

LOS ANGELES, Oct. 29 -- California doctors proceeded with an extraordinary baboon-to-baby heart transplant after indicating that they had no suitable alternative to save the child from certain death despite success by Philadelphia and Boston surgeons in treating more than 50 infants with similar heart defects.

Dr. Leonard L. Bailey, the head of a surgical team that performed the operation, said through a spokesman today that the possibility of other treatment "was explained very carefully" to the infant's parents but they opted for the transplant.

A statement issued by Bailey's university after the transplant appeared to be incomplete, however.

A news release distributed after the Friday morning transplant of a baboon's heart into a 14-day-old baby at the university medical center mentioned the work of Dr. William Norwood in Philadelphia. But the release said he had "limited success" correcting such defects and "other experienced infant heart surgeons have been unable to reproduce his results."

In a telephone interview from Philadelphia Childrens Hospital today, Norwood said that not only he but doctors at Boston Childrens Hospital have succeeded in helping children suffering from hypoplastic left heart syndrome, the condition that led to the baboon heart transplant for "Baby Fae" in Loma Linda.

He said about 40 of the 100 patients he has treated with a special two-step surgical procedure have survived. The oldest is now 4 years old, he said, and expected to lead a normal life, barring major exertions such as running a marathon. Dr. Aldo Castaneda of Boston Childrens Hospital said about 15 of his 30 most recent patients have survived.

Some experts on medical ethics have protested the use of an infant for an experimental procedure, and animal rights advocates have attacked the killing of a 7-month-old baboon for the operation. But Loma Linda University officials said the child would have died soon without the procedure, and a university ethics committee approved the operation as long as it had a chance of saving the infant. The day after the transplant, a hospital spokesman described the condition with which the baby was born as "100 percent fatal" if left untreated.

A spokesman for the medical center at the Seventh-Day Adventist university 60 miles east of Los Angeles where the transplant occurred said Baby Fae, the name used to protect the infant's identity, remained in stable condition today, with the transplanted heart performing normally. The condition of the infant, who was awake and apparently healthy, was upgraded from critical to serious late today, a hospital spokesman said.

Four previous human recipients of ape hearts in Mississippi, South Africa and Britain have survived no longer than a few days. Bailey, the head of the Loma Linda surgical team, said Sunday he once kept a goat alive with a lamb's heart for 165 days. He said he has performed nearly 150 heart transplants between animals in the last seven years and has reason to believe humans and apes may be more compatible than sheep and goats.

Given the possibility of fatal rejection of a transplant and possible harmful side effects from drugs to suppress rejection, Norwood, 43, chief of cardiac surgery at his hospital, said, "If I had my druthers I would rather use other options short of transplants." Castaneda, 54, chief of cardiac surgery at the Boston hospital and a former research partner of Norwood, said, "At least people ought to know that it is an alternative."

A spokesman for the Loma Linda University Medical Center said she did not know why the university press release erred in reporting the Norwood procedure.

At a news conference Sunday, Bailey cited a July 1983 report on Norwood's work, which he said indicated only two of 35 patients had survived the procedure.

Norwood said he could not evaluate whether the Baby Fae transplant was right or wrong without knowing the circumstances at the time of the operation. Asked if he could have helped the infant if her parents had called him before the transplant, Norwood said, "Yes."

Norwood said he is now seeing 30 to 50 babies a year with hypoplastic left heart syndrome, a congenital defect in which most of the left side of the heart is missing, and some of them have been brought from other parts of the country.

Under the procedure he uses, the circulation through the newborn heart is redirected to the route used by a fetal heart so that blood can be pumped into the body through the right rather than the missing left side. The child is sent home and after the patient's lungs have developed sufficiently in two or three years a relatively common operation called the Fontan procedure is performed. The circulation is rerouted again to allow blood returning to the heart to go directly to the lungs for a new supply of oxygen.

Carolyn Laubach, a spokesman for the U.S. Food and Drug Administration, said today neither the transplant nor the Norwood-Castaneda procedure requires federal approval because they do not involve new, experimental drugs or equipment, such as the artificial heart implanted in Seattle dentist Barney Clark.

Members of the Washington-based People for the Ethical Treatment of Animals, who picketed the university Sunday, pointed to a report that a human baby's heart had been available for transplant Friday as evidence that the operation was unnecessary.

Paul I. Terasaki, director of the California regional organ procurement agency, said the heart of a 2-month-old baby did become available the day of the operation but Loma Linda officials were not aware of it. A university spokesman said the heart would have been too big to use.

Bailey said in a statement that the difficulties of finding human heart donors for newborns and the time needed to test them made them "impractical."