FETAL TISSUE DERIVED FROM SPONTANEOUS PREGNANCY LOSSES IS INSUFFICIENT FOR HUMAN TRANSPLANTATION

Objective: To determine if sufficient fetal tissue with desirable tran splant characteristics can be obtained from spontaneous abortions. Met hods: A survey of fetal tissues collected from newly diagnosed spontan eous pregnancy losses from three Indianapolis hospitals was conducted from December 1992 to September 1993. Forty-nine of 356 mothers (13.8% ) with spontaneous abortions or ectopic pregnancies consented to the e valuation of their products of conception by gross and microscopic pat hologic examination, bacterial culture, cytogenetic analysis, cell cul ture, and maternal serologic tests. Results: Forty-nine pregnancies (g estational age range 5-30 weeks) provided four identifiable embryos, 1 2 second-trimester fetuses, and one third-trimester fetus. Nine sample s (18.4%) were of excellent or good quality on pathologic grading. Twe nty-five of 38 samples tested (66%) grew pathogenic bacteria. Maternal serologic tests were negative for antibodies to human immunodeficienc y virus, human T-cell lymphotropic virus, syphilis, and hepatitis B in all cases. One of 43 sera was reactive for hepatitis C, and 33 (77%) were positive for cytomegalovirus. Cytogenetic abnormalities were foun d in 25% of cultured samples. Five fetal brain samples had cell viabil ities of 50% or more. Few viable fetal hepatocytes were found. Only tw o fetal brain samples (4.1%) were potential candidates for human trans plantation. Conclusion: Spontaneous pregnancy losses yield minimal usa ble tissue for human transplantation because of a lack of embryonic or fetal tissues, delayed collection, decomposition, genetic abnormality , and bacterial contamination.