Surgeons who tried to save a dying woman by implanting a pig's liver defended the effort Tuesday in the face of criticism that it was morally and scientifically unjustified.
The operation was a temporary measure to keep her alive until a human liver could be found. But Susan Fowler, 26, died Monday evening after a human liver was sent to Cedars-Sinai Medical Center from Utah.
She died of complications of acute liver failure even though the pig liver transplanted Sunday was functioning, said Dr. Leonard Makowka, head of the transplant team.
Rapid deterioration in the woman's health caused doctors to choose the pig liver transplant, he said.
"We were faced with a young woman deteriorating in front of our eyes with signs of severe brain swelling," said Makowka.
"If we're faced again with this situation tonight, we would have to proceed."
But a medical ethics specialist denounced the pig liver transplant.
"There's absolutely no basis in basic research for trying a pig liver in a human being given the differences in biology between people and pigs," said Arthur Caplan, director of the Biomedical Ethics Center at the University of Minnesota at Minneapolis.
"But the gap in biology between a pig and a person at the present time is too large to morally justify subjecting any human being to a transplant of organs from a pig," Caplan said in a telephone interview.
Makowka insisted that a pig liver is suitable as a temporary measure.
"I understand his concerns . . . but Dr. Caplan hasn't had the benefit of years of research" into transplanted pig livers, Makowka said.
The surgeons didn't know why the fatal complication, brain swelling, occurred with the pig liver functioning.
Makowka was part of a team that transplanted a baboon's liver into a man in Pittsburgh in June.