鈥淭HE operation was a success but the patient died,鈥� goes the old joke.
Thankfully, no one has died in the American trial at the centre of the furore
over fetal cell transplants
(see 鈥淐atastrophe or cure?鈥�).
But five people did develop side effects. Should we be alarmed?
The surgeons say no: the problem has been exaggerated by a scaremongering
press, they claim. Their European colleagues say no鈥攂ut on the grounds
that the Americans employed surgical techniques and grafts nobody else uses.
Others say we should all simply grow up and acknowledge that without risk there
can be no medical progress. In fact, there are real worries. If European experts
are correct, the team was giving an untested type of fetal graft to a
substantial number of patients. Three of them were affected so badly by
uncontrollable movements that surgeons had to insert electrodes into their
brains to reduce the problem. Why didn鈥檛 the team start with a smaller trial,
backed by evidence of safety from animal research?
Another worry is that researchers seem unable to agree on how to standardise
either their transplant techniques or their methods of assessing patients
afterwards. Removing pieces of brain tissue from aborted fetuses and injecting
them into people鈥檚 brains is never going to be an exact鈥攐r wholly
safe鈥攕cience. Inject the wrong cells and you can kill someone鈥攁s
happened to at least one patient in a previous operation. Without an agreed way
of assessing rival techniques, we will never know which ones work and which are
safe.
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Researchers need to act swiftly. A burst of inventiveness means the whole
field of 鈥渟pare-part鈥� tissue engineering is about to explode. Some teams are
already injecting people with brain cells from pig fetuses and other sources.
Soon scientists will want to experiment with neural grafts from embryonic stem
cells. Patients with cruel and incurable brain diseases will always be willing
guinea pigs, ready to gamble on whatever comes out of the labs. Their trust
should not be abused.