Draft:Purno Saikia

Purno Saikia is the first human recipient of a pig heart and kidney s through surgery, and the first to receive non-human lungs. This is considered a landmark in the history of xenotransplantation or heterologous transplant, where living tissues or organs are transplanted from one species to another. The use of pig organs foreshadowed successful transplants in 2021 (pig kidney) and 2022 (pig heart). The surgery was conducted by surgeons Dhaniram Baruah and Jonathan Ho Kei-shing in 1996. Prior to this, the heart of a baboon had been transplanted into "Baby Fae" in 1984, along with some attempts at transplanting chimpanzee kidneys since the 1960s.

Life and medical background
Purno Saikia was born in Assam, India in the year 1965 and was a farmer by profession. Towards his early 30s, he had been diagnosed with a ventricular septal defect. In this condition, commonly referred to as "a hole in the heart", there may be an opening in the ventricular septum of varying size. Saikia's condition was grim and he was terminally ill. While on the case, Baruah claims, they tried the conventional methods of treatment, but Saikia did not respond positively to them. As a result of that, Baruah claims, the family of Purno Saikia had consented to trying out the non-conventional procedure as a last resort.

Surgery
The transplant surgery was conducted by the cardiothoracic surgeon Dhaniram Baruah from Assam in India, and his associates Jonathan Ho Kei-shing from Hong Kong and C. S. James. The surgery, which included the transplant of a heart, kidney and lungs from pig into the human patient, lasted for about fifteen hours. Baruah and his team had made no genetic modifications to the pig organs used, unlike the pig organ transplants conducted twenty-five years later in the United States. In the legal trials following the surgery, Baruah signed a statement that no organ transplant was actually done, but later claimed that the confession is false and was coerced out of him. The government of Assam confiscated Saikia's body and ordered a forensic assessment in Kolkata. The tests confirmed that the organs transplanted were indeed of a pig.

A major problem in xenotransplantation is that the human immune system rejects agents that are foreign to the body. Baruah claimed that he had "developed a new anti-hyperacute rejection biochemical solution to treat the donor’s heart and lung, and blind its immune system” to circumvent this problem. However, Baruah's solution was not long lasting, and after the surgery, Saikia survived for about one week. Several infections had crept up after the surgery and Saikia's body displayed hyperacute rejection. By the standards set by the International Society for Heart and Lung Transplantation, a xenotransplantation surgery is considered successful if the patient survives for 90 days or more, and by this standard, Purno Saikia's surgery was not a success.

Social Consequences
Dhaniram Baruah and Jonathan Ho Kei-shing were both arrested after the surgery, with the invocation of section 304 (culpable homicide not amounting to murder) of the Indian Penal Code (IPC) and section 18 of the Transplantation of Human Organs and Tissues Act, 1994 (removal of human organ without authority). They were jailed for 40 days and then released as the act did not apply to Assam at the time. Baruah had further argued that the act did not apply to xenotransplantation surgeries. Kei-shing was previously involved in another controversy and brawl with the Chinese government in 1992, when he had inserted heart valves from an ox, developed by Baruah himself, into a patient in Hong Kong.

Baruah was a fellow of the Royal College of Surgeons and Physicians, UK and was an internationally acclaimed surgeon, but public opinion turned around after the controversial procedure on Saikia. As public sentiment turned, many began to view the surgery as an injustice to Purno Saikia and his family, and as a flouting for ethical norms in medicine. An angry mob burned down Baruah's clinic in Sonapur near Guwahati in Assam. The government of Assam conducted an inquiry into the matter and concluded that the procedure was violative of legal ethical standards as Baruah's clinic had neither applied, nor obtained registration for transplant procedures.