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At autopsy,the diagnosis of PD was confirmed.Intrastriatal graft sites were identified,but contained no viable neurons;astrogliosis,focal microgliosis,and mixed inflammatory response,suggesting allograft rejection,were present.Surprisingly,the intraventricular tissues survived and showed ectodermal and mesenchymal,but no neural,differentiation,as well as cellular response;the left lateral and fourth ventricles were filled completely by this proliferated tissue.by intraventricular infusion,tissues from early-gestation sources can engraft successfully, grow,and survive for at least 23 months in the brain of a PD patient. However,contamination by,or differentiation into,nonneural tissues can occur,can lead to proliferation of tissues within ventricular spaces,and may result in ventricular obstruction.Grafts,whether intraventricular or intraparenchymal,are capable of inciting host responses,which in turn may limit their long-term survival.Finally,post-transplant clinical improvement in symptoms of PD may be unrelated to survival of engrafted neurons. |
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