Sunday, August 20, 2000		Article

MEN with courage, all over the world, are often called lion-hearted, although they literally do not have a lion’s heart. Of course, in Indian mythology, there is the mention of Nar-simha, a man with a lion’s body and a human head. Greek mythology also has a similar creature, known as the Sphinx. Majority of the intelligentsia, however, considered all these as legends only. But the latest scientific and technological advances in the field of surgery, it appears, might soon change all this we are close to bringing fiction into the realm of fact.

On January 31, 1996, a surgeon, Dr D. R. Barua, an FRCS from the Royal College of Physicians and Surgeons, Glasgow, performed an open heart operation on a patient named P.A. Saikia, and grafted the heart of a pig on to him. The patient survived for seven days. Some local doctors simply did not believe that such a thing could ever happen. Soon after the death of the patient, a great hue and cry was raised by the medical fraternity. Dr Barua was declared a ‘quack, mad-cap’ ‘crank’ and what not. Not only that, a formal FIR was also lodged against him charging him of fraud and murder. This was coupled with personal humiliation and professional disrepute. After serving 40 days in prison, he is now out on bail.

Far from being repentant about his ‘experiment’, Dr Barua told the media recently at Guwahati and Calcutta that now no one can dislodge him from the position of a pioneer in xeno-transplantation. He lambasted his critics and said that he had done nothing wrong. He had performed the operation only after the consent of the patient’s brother, who insisted that "something should be done to save the patient". Since no human heart was available, experiment for grafting a pig’s heart was done, which was partially successful in as much as that it could keep the man alive for seven days. More such experiments may be necessary to make such operations a complete success".

Dr Barua’s claim of xeno-transplanting a pig’s heart on to a human has been confirmed by the Central Research and Forensic Laboratory Hyderabad. This would give him a lot of support to fight his denigrators and conduct more such experiments to attain his objective.

Fifty years ago, nobody could think that human organs could be transplanted, but it is so common now. The pioneering work in the case of heart-transplant was done by a South African doctor, Christiaan Barnard, in 1967 after a number of trials and errors. Now heart-transplant is

quite common, though costly, because of non-availability of heart-donors. Similarly transplant of kidneys and eyes has also become quite common and their techniques are being improved everyday. In fact the transplanting of human organs of one into another, has also generated an illegal trade in human limbs, particularly the kidneys, by unscrupulous doctors, and middlemen. One group of middlemen looks for

the buyer and negotiates the price, while the other looks for donors, who, in genuine cases are generally close relations, but in fraudulent cases are mostly poor unemployed persons, who are lured to the doctor’s table by offers of money.

Non-availability of human parts had forced surgeons to think of xeno-transplanting, and Dr Barua of Guwahati is also one of them. His only fault seems to be that he has gone far ahead of his times. In support of it, I would like to quote from an article, in the Lancet by Prof Robert Lechler and his co-workers of Royal PG Medical School of London. He believes that xeno-transplantation was the only solution for the easy availability of various limbs for being grafted among humans. In his opinion, not only heart, but other parts also, like insulin-producing cells from an animal, could be transplanted on

to a person suffering from diabetes. Prof Lechler holds that because of human immune system, which promptly rejects foreign bodies, primates could be the only animals, whose limbs could be made agreeable to the human system. Among primates, the nearest ones to humans are

baboons gibbons, chimpanzees, gorillas, apes and monkeys. But, the problem with them is that they are too small in number, and some of them already facing extinction. The second difficulty with them is that like humans, they also do not breed fast and mature quite late. Therefore, they are not ideal for xeno-transplanting.

The next animal, which fits the bill is the pig. It breeds fast and is found in large numbers. In fact Dr Barua feels special pig farms could be started for the purpose. The only care he says has to be taken is against the various infectious diseases, whose virus most pigs carry. Full-fledged research may have to be done to eliminate those viruses and create a new breed of pigs for xeno-transplanting.

In fact, doctors have been seriously considering pigs to be made the biggest benefactors of mankind. They have not been only debating the possibility of making pigs virus free, but also of injecting human genes into pigs to enable them to produce human proteins, so as to neutralise the complement attack seen in hyperacute cases of rejection of foreign transplants. Once the problem of xeno-graft rejections is solved, then further experiments may be made as to what other problems come up between human and animal xeno-grafts.

According to Dr Lechler, "Physiological and biochemical similarities between humans and pigs indicate that procine organs such as the heart and kidney may function adequately in man at least for short term" (as was the case with Dr Barua’s experiment) but perhaps the same may not be true in the case of liver transplant, "because the pig’s liver will produce pig’s proteins and not humans".

Therefore, it would be wrong to dub Dr Barua a crank. He is a voracious reader of scientific journals and has already come to conclusion that in the days to come the pig would be the best friend of man to give its hearts to all those in need of it.