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Caligara C, Santamaría-López E, Hernáez MJ, Ortiz-Vallecillo A, Ruíz M, Prados N, Gonzalez-Ravina C, Fernández-Sánchez M. PGT-HLA programmes for the cure of a sick sibling: clinical strategies for this challenging search. Reprod Biomed Online 2023; 47:103400. [PMID: 37879124 DOI: 10.1016/j.rbmo.2023.103400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 10/27/2023]
Abstract
The ultimate goal of a preimplantation genetic testing and human leukocyte antigen (PGT-HLA) matching programme is the birth of a healthy, HLA-compatible child for the treatment or cure of a sick sibling. Several authors have published successful cases of the births of children HLA-matched to siblings affected by different conditions and diseases. However, there are many reports of failed attempts. Couples seeking an HLA-matched sibling for their affected child look for positive outcomes in the shortest possible time. Nevertheless, there is no published consensus or guidelines with recommendations for these cases. Here, the authors aimed to analyse different approaches for these programmes, highlighting the most promising strategies for the families and fertility units. Furthermore, the authors mention a successful case of a PGT-HLA matching programme after a previous failed attempt following the strategies proposed. Which is the most cost-effective and time-efficient approach in a PGT-HLA matching programme?
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Affiliation(s)
- Cinzia Caligara
- IVI-RMA Seville, Seville, Spain; IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Esther Santamaría-López
- IVI-RMA Seville, Seville, Spain; IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain.
| | - María José Hernáez
- IVI-RMA Seville, Seville, Spain; IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Ana Ortiz-Vallecillo
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Myriam Ruíz
- IVI-RMA Seville, Seville, Spain; IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Nicolás Prados
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain; Departamento de Biología Molecular e Ingeniería Bioquímica, Universidad Pablo de Olavide, Seville, Spain; IVIRMA Global Headquarters, Seville, Spain
| | - Cristina Gonzalez-Ravina
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain; Departamento de Biología Molecular e Ingeniería Bioquímica, Universidad Pablo de Olavide, Seville, Spain; IVIRMA Global Headquarters, Seville, Spain
| | - Manuel Fernández-Sánchez
- IVI-RMA Seville, Seville, Spain; IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain; Departamento de Biología Molecular e Ingeniería Bioquímica, Universidad Pablo de Olavide, Seville, Spain; Departamento de Cirugía, Universidad de Sevilla, Seville, Spain
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Kuliev A, Rechitsky S. Preimplantation HLA typing: Practical tool for stem cell transplantation treatment of congenital disorders. World J Med Genet 2014; 4:105-109. [DOI: 10.5496/wjmg.v4.i4.105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 08/31/2014] [Indexed: 02/06/2023] Open
Abstract
It is well known that to achieve an acceptable engraftment and survival in stem cell therapy, an human leukocyte antigens (HLA) identical stem cell transplant is strongly required. However, the availability of the HLA matched donors even among family members is extremely limited, so preimplantation HLA typing provides an attractive practical tool of stem cell therapy for children requiring HLA matched stem cell transplantation. The present experience of preimplantation genetic diagnosis (PGD) for HLA typing of over one thousand cases shows that PGD provides the at-risk couples with the option to establish an unaffected pregnancy, which may benefit the affected member of the family with hemoglobinopathies, immunodeficiencies and other congenital or acquired bone marrow failures. Despite ethical issues involved in preimplantation HLA typing, the data presented below show an extremely high attractiveness of this option for the couples with affected children requiring HLA compatible stem cell transplantation.
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