Morning Rounds: Piggyback Transplants And Antibiotics in Animals

There's always a catch. This morning's news brings two tales of unintended consequences: A "miracle surgery" with long-term complications, and "miracle drugs" fed to animals that may be making people sick.

First the surgery: Doctors and media around the world this morning are hailing the good luck of a 16-year-old Welsh schoolgirl who lived 10 years with a "piggyback" heart, and then was eventually able to have it removed after her own failing heart, surprisingly, healed completely.

Hannah Clark was a gravely ill 2-year-old with few options in 1995 when London doctors decided that grafting an extra heart (from an infant who had died) onto her own was Hannah's best chance for survival.

The radical surgery worked, and much to the surprise of her doctors, Hannah's own heart healed over time — enough so that when surgeons finally removed the "piggyback" heart, 10 years later, Hannah was able to thrive on her own.

But listen to Hannah describe how thrilled she is to be able now to live and work and play like any other teen after the extra heart was removed and you'll get a glimpse of how tough it can be to live as a transplant patient. Take too little immune suppressive medicine and you hurt the transplanted organ. Take too much and you risk serious infection or cancer (which Ms. Clark did get). Not to mention the expense.

The miracle remedy was worth it, the teen told reporters. Still, "I'm really glad I don't have to rely on life-saving drugs anymore."

Meanwhile, there are hints from a hearing yesterday on Capitol Hill that the new FDA hopes to add a measure to health overhaul legislation that would severely limit farmers' use of antibiotics in animal feed, in hopes of preserving the drugs' usefulness for people.

(Read past the jump to hear which uses of antibiotics the FDA hopes to ban and why)

 

Dr. Joshua Sharfstein, the FDA's deputy commissioner, told the House rules committee in written testimony that routinely feeding antibiotics to health chickens pigs and cattle should cease, and that farmers should only be allowed to use antibiotics in animals under the supervision of a veterinarian.

Overuse of the drugs in animals, he says, is a prime driver behind the rise of bacteria that are resistant to treatment.

Farm groups have disputed Sharfstein's claims and others like it. Dave Warner, a spokesman for the National Pork Producers Council, told the New York Times:

There are no good studies that show that some of these antibiotic-resistant diseases — and it seems like we're seeing more of them — have any link to antibiotic use in food-animal production.

Others say there's plenty of evidence, including DNA fingerprinting studies that trace the resistant bacteria making people sick back to animal feed.

In light of heightened concern over food safety in Congress, this long-simmering issue might actually flash to a boil.