The surgeon who implanted the first animal heart in a human infant was told at a medical conference four months before the operation that his research was too incomplete to risk human subjects.

An article by Dr. Leonard L. Bailey in the Journal of Thoracic and Cardiovascular Surgery, the first published by the Loma Linda University surgeon since the October operation on Baby Fae, shows that he was warned against the procedure after reporting that none of his infant animal subjects survived more than 165 days.

Heart surgeon and immunologist Dr. Alan S. Coulson, asked to comment on Bailey's research before the annual meeting of the Western Thoracic Surgical Association last June, called Bailey's work "courageous, farsighted and imaginative," but concluded that "much more information is needed on the basics of transplantation immunology as it relates to xenografting before clinical application can be considered."

"If the xenograft in a newborn human infant was accomplished and the patient lived 60 to 70 days, would we be really justified in calling this long-term survival? I do not think so," Coulson said at the conference in Maui, Hawaii, after Bailey had made his report. "I sympathize with the problem, but I think tremendous areas of research and planning are needed first."

Baby Fae, a Barstow, Calif., infant suffering from the usually lethal hypoplastic left-heart syndrome, lived nearly three weeks with her baboon heart before succumbing to the effects of natural rejection of the alien tissue and kidney failure probably prompted by drugs used to prevent rejection.

Despite an ongoing debate over the ethics of using small children in such experimental operations, Bailey has said his work provides the only hope for babies with such severely deformed hearts. He has indicated plans for future operations.

Although Bailey summarized his experiments in transplanting lamb hearts into newborn goats during news conferences at the time of the Baby Fae operation, he declined to provide a copy of the report he read in June. It was made public in the February issue of the medical journal published in St. Louis.

According to Bailey's article, entitled "Orthotopic cardiac xenografting in the newborn goat" and coauthored by Drs. Jun Jang and Walter Johnson and transplant immunologist Weldon B. Jolley, 14 newborn goats were given lamb hearts and 10 survived the transplant operation. Their individual survival rates were 24, 32, 44, 47, 60, 60, 78, 90, 120 and 165 days, for an average survival rate of 72 days.

Bailey gave each goat a new drug, cyclosporine, also given to Baby Fae to inhibit rejection of the alien heart. His earlier research indicated that this would extend survival "fourfold without increasing the risk of lethal infection." Still, all but one of the goats showed evidence of tissue rejection after their deaths.

"The animal surviving 165 days was chronically ill with evidence of anemia and right-heart failure for nearly 30 days prior to death," Bailey said.

In Coulson's review of Bailey's work, also published in the journal article, he suggested more research on heart transplants between different primates and on nonlethal animal-to-adult human kidney transplants before attempting the dangerous animal-to-human heart operation. In an interview, Coulson, who practices in Stockton, Calif., said he was surprised that no doctors in the audience questioned Bailey's research at the Maui conference.

"They may not have actually believed he was going to go through with" experiments with humans, he said. In a brief response to Coulson, Bailey said in June that he thought an infant's immature immune system made the chances of success more likely than experiments with adults would indicate. "Although I do not want to speculate at all," he said, "I believe you can guess where we are headed with this project." Colleague Warned Doctor Before Baby Fae Implant More Research Urged on Procedure By Jay Mathews Washington Post Staff Writer

LOS ANGELES -- The surgeon who implanted the first animal heart in a human infant was told at a medical conference four months before the operation that his research was too incomplete to risk human subjects.

An article by Dr. Leonard L. Bailey in the Journal of Thoracic and Cardiovascular Surgery, the first published by the Loma Linda University surgeon since the October operation on Baby Fae, shows that he was warned against the procedure after reporting that none of his infant animal subjects survived more than 165 days.

Heart surgeon and immunologist Dr. Alan S. Coulson, asked to comment on Bailey's research before the annual meeting of the Western Thoracic Surgical Association last June, called Bailey's work "courageous, farsighted and imaginative," but concluded that "much more information is needed on the basics of transplantation immunology as it relates to xenografting before clinical application can be considered."

"If the xenograft in a newborn human infant was accomplished and the patient lived 60 to 70 days, would we be really justified in calling this long-term survival? I do not think so," Coulson said at the conference in Maui, Hawaii, after Bailey had made his report. "I sympathize with the problem, but I think tremendous areas of research and planning are needed first."

Baby Fae, a Barstow, Calif., infant suffering from the usually lethal hypoplastic left-heart syndrome, lived nearly three weeks with her baboon heart before succumbing to the effects of natural rejection of the alien tissue and kidney failure probably prompted by drugs used to prevent rejection.

Despite an ongoing debate over the ethics of using small children in such experimental operations, Bailey has said his work provides the only hope for babies with such severely deformed hearts. He has indicated plans for future operations.

Although Bailey summarized his experiments in transplanting lamb hearts into newborn goats during news conferences at the time of the Baby Fae operation, he declined to provide a copy of the report he read in June. It was made public in the February issue of the medical journal published in St. Louis.

According to Bailey's article, entitled "Orthotopic cardiac xenografting in the newborn goat" and coauthored by Drs. Jun Jang and Walter Johnson and transplant immunologist Weldon B. Jolley, 14 newborn goats were given lamb hearts and 10 survived the transplant operation. Their individual survival rates were 24, 32, 44, 47, 60, 60, 78, 90, 120 and 165 days, for an average survival rate of 72 days.

Bailey gave each goat a new drug, cyclosporine, also given to Baby Fae to inhibit rejection of the alien heart. His earlier research indicated that this would extend survival "fourfold without increasing the risk of lethal infection." Still, all but one of the goats showed evidence of tissue rejection after their deaths.

"The animal surviving 165 days was chronically ill with evidence of anemia and right-heart failure for nearly 30 days prior to death," Bailey said.

In Coulson's review of Bailey's work, also published in the journal article, he suggested more research on heart transplants between different primates and on nonlethal animal-to-adult human kidney transplants before attempting the dangerous animal-to-human heart operation. In an interview, Coulson, who practices in Stockton, Calif., said he was surprised that no doctors in the audience questioned Bailey's research at the Maui conference.

"They may not have actually believed he was going to go through with" experiments with humans, he said. In a brief response to Coulson, Bailey said in June that he thought an infant's immature immune system made the chances of success more likely than experiments with adults would indicate. "Although I do not want to speculate at all," he said, "I believe you can guess where we are headed with this project."