Savior sibling: Difference between revisions

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==Indications==
 
==Indications==
A ''savior sibling'' may be the solution for any disease requiring [[hematopoietic stem cell transplantation]] (see ''[[Bone marrow transplant#Conditions treated with bone marrow or HSC transplantation|Conditions treated with bone marrow transplantation]]''). It is effective against genetically detectable (mostly [[monogenic disease|monogenic]]) diseases, e.g. [[Fanconi anemia]],<ref>Page 29 in {{cite book |author=Moore, Pete |title=The Debate About Genetic Engineering (Ethical Debates) |publisher=Rosen Central |location=New York, NY |year=2007 |pages= |isbn=1-4042-3754-2 |oclc= |doi= |accessdate=}}</ref> [[Diamond-Blackfan anemia]]<ref name=wwn>[http://www.worldwidewords.org/turnsofphrase/tp-sav1.htm SAVIOUR SIBLING] worldwidewords.org. Page created 11 Aug. 2007</ref> 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 [[leukemia]], and in such cases HLA match is the only requirement, and not exclusion of any other obvious genetic disorder.
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A ''test tube kids' may be the solution for any disease requiring [[hematopoietic stem cell transplantation]] (see ''[[Bone marrow transplant#Conditions treated with bone marrow or HSC transplantation|Conditions treated with bone marrow transplantation]]''). It is effective against genetically detectable (mostly [[monogenic disease|monogenic]]) diseases, e.g. [[Fanconi anemia]],<ref>Page 29 in {{cite book |author=Moore, Pete |title=The Debate About Genetic Engineering (Ethical Debates) |publisher=Rosen Central |location=New York, NY |year=2007 |pages= |isbn=1-4042-3754-2 |oclc= |doi= |accessdate=}}</ref> [[Diamond-Blackfan anemia]]<ref name=wwn>[http://www.worldwidewords.org/turnsofphrase/tp-sav1.htm SAVIOUR SIBLING] worldwidewords.org. Page created 11 Aug. 2007</ref> 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 [[leukemia]], and in such cases HLA match is the only requirement, and not exclusion of any other obvious genetic disorder.
   
 
==Procedure==
 
==Procedure==

Revision as of 01:40, 19 May 2011

A savior sibling (or saviour sibling) is a child who is born to provide an organ or cell transplant to a sibling that is affected with a fatal disease, such as cancer or Fanconi anemia, that can best be treated by hematopoietic stem cell transplantation.

The savior sibling is conceived through in vitro fertilization. Fertilized zygotes are tested for genetic compatibility (human leucocyte antigen (HLA) typing), using preimplantation genetic diagnosis (PGD), and only zygotes that are compatible with the existing child are implanted. Zygotes are also tested to make sure they are free of the original genetic disease. The procedure is controversial.[1][2][3]

Indications

A test tube kids' 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 anemia,[4] Diamond-Blackfan anemia[5] 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 leukemia, and in such cases HLA match is the only requirement, and not exclusion of any other obvious genetic disorder.

Procedure

8-cell human embryo, 3 days after fertilization

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

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.[5]

A survey of 4,000 Americans showed that most of them approved of PGD use for savior siblings.[6]

History

Yury Verlinsky and collaborators described the first case in 2001.[citation needed]

References

  1. ^ a b c [1] 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.
  2. ^ Choosing offspring: prenatal genetic testing for thalassaemia and the production of a 'saviour sibling' in China. Sui S, Sleeboom-Faulkner M. PMID: 19499399
  3. ^ Symbiotic relationships: saviour siblings, family rights and biomedicine. Bennett B. PMID: 17058348
  4. ^ Page 29 in Moore, Pete (2007). The Debate About Genetic Engineering (Ethical Debates). New York, NY: Rosen Central. ISBN 1-4042-3754-2. 
  5. ^ a b c SAVIOUR SIBLING worldwidewords.org. Page created 11 Aug. 2007
  6. ^ Genetic testing of embryos to pick 'savior sibling' OK with most Americans medicalnewstoday.com, Article Date: 04 May 2004 - 0:00 PDT

External links