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Preimplantation HLA typing: having children to save our loved ones
  1. K Devolder
  1. Correspondence to:
 Katrien Devolder
 Ghent University, Centre for Environmental Philosophy and Bioethics, Blandijnberg 2, B-9000 Gent, Belgium; katrien.devolderUgent.be

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.

  • DBA, diamond blackfan anaemia
  • HLA, human leukocyte antigen, HSC, haematopoietic stem cell
  • PGD, preimplantation genetic diagnosis
  • histocompatibility testing
  • preimplantation diagnosis
  • haematopoietic stem cells
  • tissue donors
  • embryo

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Footnotes

  • i A person’s human leukocyte antigen type is determined by her antigen pattern, that is, the markers on the surface of body cells and tissues. They are used by the immune system to distinguish one’s own body cells and tissues from foreign ones.

  • ii In the Curry case a couple in the US had a daughter, Natalie Curry, with Fanconi’s anaemia. The couple decided to have another child in the hope that it would be a tissue match for Natalie. The woman became pregnant, but the fetus miscarried. After one month she was pregnant again, and a healthy baby, Audrey, was born. Unfortunately, Audrey was an unsuitable donor. Within 12 weeks the woman was pregnant again. Emily was born healthy and was a match. Twenty months after Emily’s birth, cord blood was transplanted into her sister, who was then four years old. Two years later Natalie was cured.4

  • iii Thanks to Nick Bostrom for very helpful feedback.

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