Neural transplantation in Huntington's disease: the NEST-UK donor tissue microbiological screening program and review of the literature.
Neural transplantation of human fetal tissue for Huntington's disease (HD) is now entering the clinical arena. The safety of the procedure has now been demonstrated in a number of studies, although the efficacy of such an approach is still being investigated. Stringent but practicable screening of the donor tissue for potential pathogens is an essential prerequisite for successful implementation of any novel transplant program that uses human fetal tissue. In this article we summarize the UK-NEST protocol for the screening of human fetal tissue being grafted to patients with mild to moderate HD. We describe the results of microbiological screening of 87 potential tissue donors in a pilot study, and of the first four donor-recipient patients included in the UK-NEST series. The rationale for the adoption and interpretation of the various tests is described and our methodology is compared with those previously used by other centers. This article therefore presents a comprehensive, logical yet pragmatic screening program that could be employed in any clinical studies that use human fetal tissue for neurotransplantation.
Farrington
M
M
Clinical Microbiology and Public Health Laboratory, Health Protection Agency & Addenbrooke's Hospital, Cambridge, UK. mark.farrington@addenbrookes.nhs.uk
Wreghitt
T G
TG
Lever
A M L
AM
Dunnett
S B
SB
Rosser
A E
AE
Barker
R A
RA
D016380:Brain Tissue Transplantation / Q000379:methods*; D026661:Clinical Trials Data Monitoring Committees; D003342:Corpus Striatum / Q000196:embryology / Q000382:microbiology / Q000601:surgery / Q000637:transplantation*; D046148:Donor Selection / Q000379:methods; D016332:Fetal Tissue Transplantation / Q000379:methods*; D006801:Humans; D006816:Huntington Disease / Q000503:physiopathology / Q000601:surgery*; D006113:United Kingdom