US surgeons have successfully implanted a heart from a genetically modified pig in a human patient, a first of its kind procedure. Picture: University of Maryland School of Medicine/ AFP
US surgeons have successfully implanted a heart from a genetically modified pig in a human patient, a first of its kind procedure. Picture: University of Maryland School of Medicine/ AFP

Who deserves a heart transplant?

By The Washington Post Time of article published Jan 15, 2022

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Deserving or undeserving of survival? Hero or villain? In the case of David Bennett Sr. - pig's heart transplant recipient and former felon - those categories are not relevant as a matter of law and medical ethics. Doctors swear an oath to treat those who are sick, and lack the authority to make moral judgments that would sort sinners from saints.

Yes, Bennett agreed to undergo the unprecedented transplant surgery earlier this month, in which he received a genetically modified pig's heart to replace his own, which was failing. And yes, he is a felon, having served six years of a 10-year sentence three decades ago for stabbing a man seven times, leaving him paralyzed and relegating him to a wheelchair for nearly 20 years.

Bennett is 57 years old now. He was 23 in 1988 when he stabbed Edward Shumaker, who died in 2007. The most pertinent thing that can be said about Bennett now is that he was a willing subject and patient - willing largely because he was out of options. Having suffered heart failure starting in the fall, he was deemed ineligible for a conventional heart transplant both because of the severity of his medical condition and, according to his son, his history of failing to follow doctors' orders and attend follow-up appointments.

"It was either die or do this transplant," Bennett said in a statement the day before his Jan. 7 operation. The procedure with the pig's heart, which he called "a shot in the dark," was his last chance.

In fact, if anyone can stake a claim to the title of pioneer in this story, it is Bartley Griffith, the doctor who performed the transplant surgery at the University of Maryland Medical Center in Baltimore. Griffith, a distinguished surgeon who was the founding director of a center for artificial organ development at the University of Pittsburgh Medical Center more than 30 years ago, might even be regarded as a hero. For if Bennett survives - and that remains a big if - it would suggest that similar transplants using pig hearts hold the potential for saving untold numbers of lives.

As of March 2020, more than 3,600 Americans were on the waiting list for a heart transplant; roughly 20% of those on that list die before a human heart becomes available, or get too sick to qualify for the procedure, according to the American Heart Association.

No one knows how many recipients of new hearts lived upstanding lives. None are or should be asked to list the worst mistake they ever made, or have it vetted as a condition of being placed on the wait list. Who could be vested with the authority to make that call, and according to which rules? Should loyal spouses be first in line for scarce organ transplants, ahead of philandering ones? Would a corrupt politician get first dibs if she passed lifesaving legislation? Or an honest one who opposed the same measure?

The germane question is whether patients needing transplants could survive with a pig's heart beating in their chests if no human heart were available. Griffith and Bennett are helping to answer that.

The Washington Post

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