Transfusion for Hepatitis

As countless victims know, infectious hepatitis is almost always a nagging, disabling disease, with some symptoms that persist for many months. But in a few cases, perhaps three out of a thousand, it is a fulminating infection that throws the victim into a coma and may cause death within a few days. Only in the past four years has an effective treatment for this form of hepatitis been developed; one man who is walking proof of its value is Peace Corps Volunteer John M. Bayne, 24.

A lanky Harvard graduate, Bayne had worked for almost a year in Maharashtra state in India, demonstrating new types of seed to farmers and helping them to fight rats. In the village he drank unboiled water. Bayne's first clue that something was amiss came in mid-August, when cigarettes "just didn't taste good." He quit smoking. A week later, he was nauseated and running a fever. The Peace Corps got him into Bombay's Breach Candy Hospital, where physicians at first thought that this was going to be a routine case. They reported: "Condition satisfactory. Do not notify family."

90% Knocked Out. Four days later, John Bayne was in a coma from what doctors call acute yellow atrophy of the liver. The virus had damaged so many liver cells that metabolic wastes were piling up and poisoning him. Alarmed doctors notified John's father, Peter F. Bayne, a school administrator in Claremont, Calif., and the Peace Corps called on Dr. Charles Trey, a South African-born research physician now at Harvard. Trey managed to get to Bombay in two days. He estimated that 90% of young Bayne's liver had been knocked out and gave him only a 10% chance of survival. Even that depended on the treatment that Trey had devised, in which the patient has a series of exchange transfusions. Much of his blood is drained out and replaced, removing the poisonous wastes from his body and giving the liver a chance to rest and regenerate.

Bayne had transfusions totaling 14 pints in Bombay, but remained in a coma. To make sure of an adequate supply of hepatitis-free blood from fellow volunteers, the Peace Corps chartered a plane and flew Bayne to Colombo, Ceylon, where the hospital ship Hope was anchored. Aboard the Hope, after more transfusions, Bayne emerged from his coma and began a slow but so far steady recovery. Last week, back home in Claremont, he felt strong enough to begin walking again. He can expect to be completely recovered in about three months. All he can remember of his brush with death is being admitted to the hospital in Bombay, then waking up aboard the Hope in Colombo.

Although the Peace Corps gives all its volunteers massive shots of gamma globulin every four to six months, infectious hepatitis is still their occupational disease because of the unsanitary conditions where they work. In the U.S., a majority of the approximately 150 cases of acute yellow atrophy reported each year are caused by infectious hepatitis, Trey believes. Even with his exchange-transfusion treatment, the survival rate is only 22%, but that is far better than the pretransfusion 10%.

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