What place do "saviour siblings" have in paediatric transplantation:
establishing the role of pre-implantation genetic diagnosis with HLA typing
Samuel GN, Strong KA, Kerridge I,
Jordens CF, Ankeny R, Shaw PJ.
Universtiy of Sydney, Australia.
Arch Dis Child. 2008 Aug 6.
ABSTRACTBACKGROUND: Not all children in need of a haematopoietic stem cell transplant have a suitable relative or unrelated donor available. Recently, in vitro fertilization (IVF) with pre-implantation genetic diagnosis (PGD) for human leukocyte antigen (HLA) tissue typing has been used to selectively transfer an IVF embryo in order to produce a child who may provide umbilical cord blood for transplantation to an ill sibling. Such children are sometimes called "saviour siblings". OBJECTIVE: To examine the published clinical and epidemiological evidence relevant to the use of this technology, with the aim of clarifying those situations where IVF and PGD for HLA-typing should be discussed with parents of an ill child. DESIGN: A critical analysis of published literature on: comparative studies of umbilical cord blood versus other sources of stem cells for transplantation; comparative studies of matched unrelated donor versus matched related donor transplantation; and the likelihood of finding an unrelated stem cell donor. CONCLUSION: IVF and PGD for HLA-typing is only applicable when transplantation is non-urgent and parents are of reproductive age. Discussions regarding this technology may be appropriate where no suitable related or unrelated donor is available for a child requiring a transplant, or where no suitable related donor is available and transplantation is only likely to be entertained with a matched sibling donor. Discussion may also be considered in the management of any child lacking a matched related donor who requires a non-urgent transplant or may require a transplant in the future.Biohappiness
Eugenics before Galton
The literature of eugenics
Germline genetic engineering
Preimplantation genetic diagnosis
Beneficence, determinism and justice
A life without pain? Hedonists take note'
'The Principle of Procreative Beneficence'
Transhumanism (H+): toward a Brave New World?
Designer baby" changed to French for "double hope baby"
and further reading
The Good Drug Guide
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
MDMA: Utopian Pharmacology
Critique of Huxley's Brave New World