Mar 22, 2002
NEW YORK (Reuters Health)
Human fetal striatal cells can be successfully transplanted into patients with Huntington's disease (HD), according to a report published in the March 12th issue of Neurology. However, subdural hemorrhage is a relatively common postoperative complication.
Dr. Robert A. Hauser, from the University of South Florida in Tampa, and colleagues assessed the outcomes of seven patients with symptomatic HD who underwent bilateral human fetal striatal transplantation.
Each of the patients received two to eight fetal striata per side in a two staged procedures, the authors note. The grafts were harvested from the lateral ventricular eminence of fetal donors several weeks after conception. The immunosuppression regimen consisted of 6 months of cyclosporine therapy.
Subdural hemorrhage developed in three patients and surgical drainage was required in two of the cases, the researchers state. One patient died 1.5 years after surgery from causes unrelated to the transplantation. Analysis of brain tissue from this patient revealed good integration of the striatal graft with no evidence of immune rejection.
Overall, transplantation was not associated with a significant improvement in motor scores from baseline, the researchers state. However, further analysis, excluding a patient who experienced cognitive and motor impairment secondary to a subdural hemorrhage, did reveal a significant improvement in motor function following surgery (p = 0.03).
The current findings indicate that striatal tissue can be transplanted into HD patients and that the cells do survive. The results also suggest that patients with moderately advanced disease are at risk for subdural hemorrhage. "If further trials are undertaken they should be performed in patients with less atrophy," the authors emphasize.
In a related editorial, Dr. J. Timothy Greenamyre, from Emory University in Atlanta, and Dr. Ira Shoulson, from the University of Rochester in New York, comment that the current feasibility study does not really add much to what was already known about transplantation in HD.
The current findings help clarify the risks associated with transplantation, but the benefits of such therapy are still unclear, the editorialists note. "It seems like a good time to pause, call for patience (rather than patients), and embark on a more dispassionate approach to tissue implantation as an experimental therapeutic intervention for HD."
© 2002 Reuters Ltd