Preimplantation HLA typing: having children to save our loved ones

Abstract

Preimplantation tissue typing has been proposed as a method for creating a tissue matched child that can serve as a haematopoietic stem cell donor to save its sick sibling in need of a stem cell transplant. Despite recent promising results, many people have expressed their disapproval of this method. This paper addresses the main concerns of these critics: the risk of preimplantation genetic diagnosis (PGD) for the child to be born; the intention to have a donor child; the limits that should be placed on what may be done to the donor child, and whether the intended recipient can be someone other than a sibling. The author will show that these concerns do not constitute a sufficient ground to forbid people to use this technique to save not only a sibling, but also any other loved one’s life. Finally, the author briefly deals with two alternative scenarios: the creation of a human leukocyte antigen (HLA) matched child as an insurance policy, and the banking of HLA matched embryos.

Preimplantation HLA typing for stem cell transplantation treatment of congenital and acquired bone marrow failures

“…In conclusion, despite ethical issues involved in preimplantation HLA typing [28][29][30][31], the presented results show the increasing attractiveness of this option for the couples with affected children requiring HLA compatible stem cell transplantation. So, the couples at risk of having children with congenital bone marrow disorders have to be informed about presently available option not only for avoiding the birth of affected child, but also for selecting a suitable stem cell donor for their affected siblings, which may presently be a realistic hope for treating of siblings with congenital bone marrow failures.…”

Ethical dilemmas associated with genetic testing: which are most commonly seen and how are they managed?

“…PGD to immunologically match a sibling to a sick child [4][5]11 Selecting an embryo with a human leukocyte antigen-type match to save the life of a sick older sibling.…”

‘Saviour Siblings’? The Distinction between PGD with HLA Tissue Typing and Preimplantation HLA Tissue Typing

“…This particular risk level must then be compared to the perceived benefits of PGD/HLA tissue typing, as it should only be permissible if the child to be born "is likely to derive enough benefit to outweigh these risks" [8]. This ratio may very well tilt in favor of PGD with HLA typing but not Preimplantation HLA tissue typing.…”