A Liver's Best Friend

Thanks to drugs, surgery and mechanical devices, a failing heart need not be fatal. Machines or transplants can also preserve life when the kidneys stop working. The patient whose liver can no longer metabolize and dispose of his body's poisonous wastes, however, eventually lapses into a coma and dies. Exchange transfusions to replace most of his blood may help for short periods, but no machine yet devised can substitute for the organ, and the livers of pigs and calves have proved inadequate to the task of cleansing human blood. Now it appears that in a liver coma crisis, man's best friend may be the dog-faced baboon.

Researchers and surgeons tried pumping human blood through baboon livers as early as 1965. Since then, Virginia Commonwealth University's Dr. David Hume and a team of colleagues headed by the Medical College of Georgia's Dr. George Abouna have refined the technique. Their findings, reported in the British Medical Journal, offer new hope for many victims of liver failure.

The Abouna group's first two patients were suffering from fulminating viral hepatitis, which had completely shut down their liver function. Death was only hours away when Abouna resorted to the use of baboons. The animals were given fatal doses of anesthesia. Their excised livers were then washed in order to remove, as much as possible, the proteins that might trigger a reaction in the patient. Finally, the patients' circulatory systems were hooked up to the blood vessels of the isolated livers, which rested at bedside in stainless steel chambers. While the patients' blood circulated through the baboon livers, their own livers had a chance to rest and recover.

Debra Jackson, 13, had previously undergone three complete exchange transfusions, yet remained comatose. Six hours after being connected to a baboon liver, she made spontaneous movements and showed normal reflexes. After 13 1/2 hours, she spoke; in two weeks she was walking. Although it took three months of intensive hospital treatment to make her fully healthy again, she is now back at school. The second patient, Mrs. Yvonne Royster, 24, had a similar experience; seven months after treatment, say the doctors, "she was in excellent health looking after her children and working as a part-time waitress."

No one knows just how many patients die each year of hepatic coma, but they certainly number in the thousands. Those whose livers have not been irreparably damaged could probably benefit from the Abouna method, which, unlike some other exotic procedures, does not involve long waits or inordinate costs. While baboons are not as plentiful as alley cats, they are being raised in several U.S. primate colonies, and as they only cost about $250 apiece, they are relatively inexpensive animals.

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