News reports in early July related to transplantation focused on transmission of a brain tumor with a liver transplant, the linking of a diabetes drug with hepatotoxicity, and duplication of embryonic cow cells.
The Lancet (1998;352:31) has reported the transmission of a brain tumor with a liver transplant. Stephan Frank and colleagues at Technical University of Desden in Germany wrote that a 29-year-old patient died from donor-transmitted metastases from a gliomatous tumor five months after receiving the liver of a 47-year-old woman who died of glioblastoma multiforme. The donor's two kidney recipients showed no signs of cancer more than four years after transplantation. In an accompanying commentary (1998;352:2-3), Patrick J. Healey and Connie L. Davis of the University of Washington Medical Center in Seattle note that only about 1% of liver donors die of primary central nervous system tumors and that transmission of such tumors is rare. Although the new report "justifies caution with and further investigation of the use of patients with brain tumours as organ donors," they wrote, "…there are too few organs for transplantation for 1% of the liver-donor pool, as well as 1% of the total organ-donor pool, to be dispensed with."
The new diabetes drug Rezulin (troglitazone) has been linked with two cases of severe hepatotoxicty and one case of liver failure leading to liver transplantation, according to two reports published July 1 in Annals of Internal Medicine and at www.acponline.org. Norman Gitlin, MD, and colleagues at Emory University School of Medicine in Atlanta, who reported the two cases of hepatotoxicity, said that "physicians and patients must be aware of this potential adverse association" (1998;129:36-38). Brent A. Neuschwander-Tetri, MD, and coauthors at St. Louis University School of Medicine in St. Louis contributed the second report (1998;129:38-41). In June, the National Institute of Diabetes and Digestive and Kidney Diseases stopped a trial, which was designed to test whether Rezulin could prevent diabetes, after one of the study participants developed liver failure.
Progress has been reported in the development of a technique that the Associated Press has said "could one day provide an off-the-shelf supply of tissues for human transplantation." In the July issue of Nature Biotechnology (1998;16:642-646), Jose B. Cibelli and colleagues at the University of Massachusetts and elsewhere said that they have found a way to produce an endless supply of embryonic cow stem cells. They reported that "somatic cells can be genetically modified and then dedifferentiated by nuclear transfer into embryonic stem-like cells, opening the possibility of using them in differentiation studies and human cell therapy."
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