Using preimplantation genetic diagnosis to create a stem cell donor: Issues, guidelines & limits

In late 1999, preimplantation genetic diagnosis was used successfully to create an HLA-matched donor without Fanconi anemia (FA) for a sibling with FA, resulting in effective hematopoietic stem cell transplant from umbilical cord blood. Despite growing attention to the combination of IVF, PGD to create a donor, and stem cell transplant, analyses have not yet addressed the full range of clinical, ethical, and legal concerns raised by creating a child to serve potentially as a lifelong donor to another. This article, from the university performing the successful stem cell transplant in the index case, proposes guidelines and limits for practice.