Savior sibling: Difference between revisions
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{{See|Preimplantation genetic diagnosis}} |
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Revision as of 12:50, 6 October 2009
A savior sibling is a child that has gone through preimplantation genetic diagnosis (PGD) for human leucocyte antigen (HLA) typing, in order to match as a donor to a previously born sibling with a disease that requires hematopoietic stem cell transplantation.[1][2][3]
Indications
A savior sibling may be the solution for any disease requiring hematopoietic stem cell transplantation (see Conditions treated with bone marrow transplantation). It is effective against genetically detectable (mostly monogenic) diseases, e.g. Fanconi anaemia, Diamond-Blackfan anemia[4] and β-thalassemia, in the ailing sibling, since the savior sibling can be selected to not have inherited the disease. The procedure may also be used in children with leukaemia, and in such cases HLA match is the only requirement, and not exclusion of any other obvious genetic disorder.
Procedure
Multiple embryos are created and preimplantation genetic diagnosis is used to detect and select ones that free of a genetic disorder and that are also a HLA match for an existing sibling who requires a transplant. Upon birth, umbilical cord blood is taken and used for hematopoietic stem cell transplantation.
Laws
- In the United Kingdom, the Human Fertilisation and Embryology Authority (HFEA) has ruled that it is lawful to use modern reproductive techniques to create a saviour sibling.[4]
- In Victoria, Australia, use of PGD for HLA typing is reviewed by the Infertility Treatment Authority on a case by case basis.[1]
Ethical considerations
Arguments for or against the use of PGD/HLA tissue typing are based on several key issues including the commodification and welfare of the donor child.[1]
The main ethical argument against is the possible exploitation of the child, e.g. potential adverse psychological effects on a child born not for itself but to save another.[4]
On the other hand, the Kantian imperative may not be breached since the future donor child will not only be a donor but also a loved individual within the family.
A survey of 4,000 Americans showed that most of them approved of PGD use for savior siblings.[5]
History
Yury Verlinsky and collaborators described the first case in 2001.
References
- ^ a b c Siblings’? The Distinction between PGD with HLA Tissue Typing and Preimplantation HLA Tissue Typing Journal Journal of Bioethical Inquiry Publisher: Springer Netherlands ISSN: 1176-7529 (Print) 1872-4353 (Online) Issue: Volume 4, Number 1 / April, 2007 DOI: 10.1007/s11673-007-9034-9 Pages: 65-70 Subject Collection: Medicine SpringerLink Date: Friday, March 02, 2007 that can be a donor for the sick child.
- ^ Choosing offspring: prenatal genetic testing for thalassaemia and the production of a 'saviour sibling' in China. Sui S, Sleeboom-Faulkner M. PMID: 19499399
- ^ Symbiotic relationships: saviour siblings, family rights and biomedicine. Bennett B. PMID: 17058348
- ^ a b c SAVIOUR SIBLING worldwidewords.org. Page created 11 Aug. 2007
- ^ Genetic testing of embryos to pick 'savior sibling' OK with most Americans medicalnewstoday.com, Article Date: 04 May 2004 - 0:00 PDT