Fetal neural
transplantation has been shown to be a feasible, safe, and according to a number of recent reports, effective treatment for
Parkinson's disease (PD). Fetal striatal
transplantation may be as feasible, safe, and effective a treatment for
Huntington's disease (HD), a disorder for which there is currently no effective treatment. This report describes our experience with fetal striatal
transplantation to adult striatum in three HD patients. Three moderately advanced, nondemented HD patients received
transplantation of fetal striatal tissue. The striatal precursor was selectively obtained from the lateral ganglionic eminence. Each patient received bilateral
grafts from five to eight donors, placed into the caudate nucleus (one
graft on each side) and the putamen (four
grafts on each side). All three patients had HD as documented by family history,
DNA heterozygosity (17-20 and 48-51 repeats), magnetic resonance imaging (MRI) revealing striatal
atrophy, and
2-deoxyglucose positron emission tomography revealing striatal hypometabolism. All patients had been evaluated using the Unified
Huntington's Disease Rating Scale and appropriate neuropsychological tests for at least 3 months prior to
transplantation. One year following
transplantation, MRI of all three patients revealed that the
grafts survived and grew within the striatum without displacing the surrounding tissue. No patients demonstrated adverse effects of the surgery or the associated
cyclosporin immunosuppression, nor did any patient exhibit deterioration following the procedure. The limited experience provided by these three patients indicates that
fetal tissue transplantation can be performed in HD patients without unexpected complications.