A newborn can provide life-saving cells for their siblings with beta thalassaemia major .
the world to use high-definition direct HLA matching because finding a precise match for the stricken sibling before transplanting the embryo into the mother ’ s womb gave its parents complete assurance that their new baby would be a saviour sibling ,” he said .
In addition to accurate embryo matching , the other key to the success of this breakthrough procedure lies in the use of stem cells . Not only are they the first cells the body produces , but they also have the potential to develop into many different types of cells while serving as a means to repair defects . Since the efficacy of stem cells reduces as we get older , the freshest , most effective stem cells are those found in the cord blood of a newborn baby .
Cord blood contains predominantly hematopoietic stem cells that have the potential to generate blood cells and cells of the immune system . Essential in fighting the underlying causes of various types of diseases and conditions , they ’ re less prone to developing graft-versus-host disease ( GVHD ) after transplant than stem cells harvested from other sources . GVHD occurs when immune cells from the donor attack the new host ’ s tissues .
For the procedure to be effective , stem cell-rich cord blood needs to be harvested immediately after the sibling ’ s birth . The stem cells are then be transplanted into the patient to provide a cure for beta thalassaemia major .
While HLA typing represents a major innovation , the genetic selection of embryos to produce saviour siblings is not new , having first come to prominence at the turn of the century when the first cases were recorded in America , Britain , and Australia . At the time , ethical debates erupted in each of these countries .
While it was already commonplace to select embryos to ensure children born through IVF would be free of genetic disease , selecting them to serve as saviour siblings perplexed both fertility specialists and ethics experts .
In a 2004 report in the Journal of Medical Ethics which examined the use of saviour siblings , the authors looked at three main arguments for whether the technique should be banned : that saviour siblings would be treated as commodities , that the practice would lead to the creation of so-called “ designer babies ”, and that saviour siblings would be physically and / or psychologically harmed .
Despite such compelling arguments , the study found the claims “ wanting ”, and the authors concluded that the selection of saviour siblings should be permitted , especially since prohibiting it would result in the preventable deaths of a number of existing children .
Prior to the study , headlines had been screaming about “ designer babies ” after the British Medical Association gingerly gave permission for the use of saviour siblings in 2002 , including an endorsement by the body ’ s head of ethics , Professor Vivienne Nathanson .
“ It ’ s a tiny step down that line , but it ’ s the kind of step that I think very many people will support ,” she said at the time .
“ Most people feel alienated by the idea of a designer baby where you choose the eye colour or the hair colour , or something really rather flippant and unimportant .
“ But the idea that the child may be able to be a donor to an older sibling is rather different , and particularly if you can use blood from the umbilical cord , which poses no risk of pain or discomfort or anything else to the newborn child ,” Dr Nathanson argued .
Though the debate has died down , critics of saviour siblings are still out there , particularly in the pro-life lobby .
But for people like the new baby ’ s father , a devout Muslim , the issue is no a longer theoretical one . He ’ s a steadfast supporter of saviour siblings , especially when the accuracy of high-definition HLA can eliminate any likelihood of a genetic mismatch that would require an abortion .
“ I would advise any parents of a child with thalassaemia that this option is there ,” Nasih said . “ They should avoid an abortion and always try to have their child safely , rather than taking a risk with their child ’ s life . I would recommend and request all the parents to go by this .” n
Cord blood contains predominantly hematopoietic stem cells that have the potential to generate blood cells and cells of the immune system .
GlobalHealthAsiaPacific . com APRIL 2021
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