Bilateral caudate and putamen grafts of embryonic mesencephalic tissue treated with lazaroids in Parkinson's disease

Five parkinsonian patients were transplanted bilaterally into the putamen a nd caudate nucleus with human embryonic mesencephalic tissue from between s even and nine donors. To increase graft survival, the lipid peroxidation in hibitor tirilazad mesylate was administered to the tissue before implantati on and intravenously to the patients for 3 days thereafter. During the seco nd postoperative year, the mean daily L-dopa dose was reduced by 54% and th e UPDRS (Unified Parkinson's Disease Rating Scale) motor score in 'off phas e was reduced by a mean of 40%. At 10-23 months after grafting, PET showed a mean 61% increase of 6-L-[F-18]fluorodopa uptake in the putamen, and 24% increase in the caudate nucleus, compared with preoperative values. No obvi ous differences in the pattern of motor recovery were observed between thes e and other previously studied cases with putamen grafts alone. The amount of mesencephalic tissue implanted in each putamen and caudate nucleus was 4 2 and 50% lower, respectively, compared with previously transplanted patien ts from our centre, Despite this reduction in grafted tissue, the magnitude s of symptomatic relief and graft survival were very similar, These finding s suggest that tirilazad mesylate may improve survival of grafted dopamine neurons in patients, which is in agreement with observations in experimenta l animals.