Saviour embryos? Preimplantation genetic diagnosis as a therapeutic technology

Preimplantation diagnosis for β-thalassemia combined with HLA matching: first “savior sibling” is born after embryo selection in Brazil

“…The selection of savior siblings has been the topic of ethical and social dilemmas, and several authorities concluded that it is ethical and also legally permissible in a number of jurisdictions [13]. According to the ESHRE PGD Consortium guidelines, consideration should be given to the time required for the PGD test to be developed and applied and for an HLA-matched sibling to be born: cases in which the affected child has an acute medical condition prohibiting safe stem cell transplantation or an extremely low life expectancy should be excluded [5].…”

“…The success of haematopoietic stem cell (HSC) transplantation will depend on the ability of the human leukocyte antigen (HLA) types of the donor and recipient to match. When the search for compatible donors in bone marrow living donor banks and databases is exhausted, the only way to save the life of a child may be to use preimplantation genetic diagnostic (PGD) to facilitate the birth of a child who can be a matching tissue donor, the so called "savior siblings" [13].…”

New Perspectives on Paternalism and Health Care

“…While PGD is admissible in Germany solely for the purpose of testing embryos for monogenic diseases (such as cystic fi brosis or Duchenne muscular dystrophy) or chromosomal abnormalities (mainly autosomal monosomy and trisomy), it is used in other countries for identifying certain desired genetic features. Thus, HLA typing can be performed in order to determine the compatibility of a bone marrow donation from a future child to save a critically ill child (so-called "donor siblings") (Sparrow and Cram 2010 ). Another aim of PGD is to determine the sex of the embryo not for medical reasons but for social or familial reasons (known as "sex balancing").…”

Preimplantation Diagnosis for Single Gene Disorders

“…49 In both situations, the goal is to conceive a healthy offspring that can save an already gravely sick child, the so-called "savior" sibling. 50 Kahraman et al recently reported, in one of the largest studies to date, birth of 59 healthy and HLA-matched children with 21 siblings cured from their respective diseases by hemapoietic stem cell transplant. 51 Several difficulties are inherent in the process of PGD with HLA typing.…”