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EMBRYONIC STEM CELLS

The Future (R)evolution of Preimplantation Genetic Diagnosis/Human Leukocyte Antigen Testing: Ethical Reflections

^aResearch Institute Growth and Development, Faculty of Health, Medicine and Life Sciences, Section Health, Ethics and Society, Maastricht University, Maastricht, The Netherlands;
^bResearch Centre Reproduction and Genetics, Universitair Ziekenhuis Brussel, Brussels, Belgium

Key Words. Human leukocyte antigen typing • Ethics • Embryonic stem cells • Hematopoietic stem cells Preimplantation genetic diagnosis

Correspondence: Guido de Wert, Ph.D., Faculty of Health, Medicine and Life Sciences, Research Institute Growth & Development, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Telephone: 0031.433882145; Fax: 0031.433884171; e-mail: g.dewert{at}zw.unimaas.nl

Received October 5, 2006; accepted for publication March 29, 2007.
First published online in STEM CELLS EXPRESS   May 24, 2007.



There has been increasing support for combining preimplantation genetic diagnosis (PGD) for specific diseases with a test for human leukocyte antigens (HLA) because the generation of HLA-matched umbilical cord blood cells may save the life of a diseased sibling. To date, this procedure has taken place in the context of conceiving another child—PGD/HLA testing type 1. However, it may well become possible to perform PGD/HLA testing outside this context, that is, to select matched embryos from which embryonic stem cells could be derived and used in cell therapy—PGD/HLA testing type 2. A proactive ethical analysis is needed and is presented in this article. Although PGD/HLA testing type 1 can be morally justified, the risks, pitfalls, and practical limitations of this procedure make it necessary to develop alternative strategies. PGD/HLA testing type 2 may provide an alternative strategy. From an ethical point of view, the controversial issue is that this procedure creates embryos purely for instrumental use. However, given the dominant view that the preimplantation embryo has only limited moral value, this alternative may be as morally justified as PGD/HLA testing type 1.

Disclosure of potential conflicts of interest is found at the end of this article.