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J Med Ethics 34:e1 doi:10.1136/jme.2007.022913
  • Clinical ethics
    • Electronic pages

Ethical reflections on clinical trials with human tissue engineered products

  1. L Trommelmans1,
  2. J Selling2,
  3. K Dierickx1
  1. 1
    Centre for Biomedical Ethics and Law, KULeuven, Leuven, Belgium
  2. 2
    Department of Theological Ethics, KULeuven, Leuven, Belgium
  1. Leen Trommelmans, Centre for Biomedical Ethics and Law, KULeuven, Kapucijnenvoer 35/3 Box 7001, 3000 Leuven, Belgium; Helena.Trommelmans{at}med.kuleuven.be
  • Received 30 August 2007
  • Revised 28 January 2008
  • Accepted 31 January 2008

Abstract

Ex-vivo tissue engineering is an emerging medical technology. Its aim is to regenerate tissues and organs and to restore them to full physiological activity. Some clinical trials with human tissue engineered products (HTEPs) have been conducted and others will follow. These trials not only have to confirm the therapeutic value of the HTEP, they also have to provide insight in its regenerative activity, its safety and long-term effects. The development of these trials is aggravated by the complexity of the tissue engineering process and product. This paper investigates how this complexity influences the ethical conduct of clinical trials with HTEPs. We focus on the value and validity of the trial, the risk-benefit ratio and the protection of the trial participant. We argue that trials with HTEPs need a robust methodology. The risk-benefit ratio of a new HTEP must be determined and compared with available efficacious therapies. This requires the identification and minimisation of risks associated with tissue engineering. Finally a process as complex as tissue engineering presents serious challenges for the informed consent process, and for the protection of the trial participant during and after the trial.

Footnotes

  • Competing interests: None.

  • Funding: Supported by the STEPS-project, funded by the European Commission, FP6-50046.