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.


BACKGROUND: 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.
Julian Savulescu
Private eugenics
'Designer babies'
Procreative liberty
Personal genomics
Genetic enhancement
Ashkenazi intelligence
Eugenics before Galton
Scandanavian eugenics
The literature of eugenics
Human self-domestication
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

BLTC Research
Utopian Surgery?
The Good Drug Guide
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
MDMA: Utopian Pharmacology
Critique of Huxley's Brave New World