10 January 2011
ByAppeared in BioNews 590
A life-saving tissue transplant from a 'saviour sibling' has been carried out entirely in Britain for the first time. Nine-year old Megan Matthews has a condition called Fanconi anaemia, which leaves her body unable to fight infection and she requires a blood transfusion every few weeks.The only hope of a cure for Megan was for her to have a bone marrow transplant from a matched donor. Tests on her older brother Stuart showed he was not a match and the bone marrow register also had no success.
If Megan's parents conceived another child naturally they only had a one in four chance of having a child that could donate tissue, and they also faced the possibility of having another child with the same condition. So Mrs Matthews underwent IVF treatment resulting in two embryos that were free of the condition, and a match for Megan was implanted by CARE Fertility in Nottingham.
Baby Max was born on 22 July 2009 and stem cells from his umbilical cord were harvested immediately. In July last year at the Bristol Royal Hospital for Sick Children, medical teams from Cambridge, Bristol and Nottingham transplanted Max's healthy bone marrow and stem cells into his sister Megan. Since the treatment Megan has been making good progress and now only requires a weekly check-up at Addenbrookes hospital in Cambridge. She may be able to stop taking some of her medication by the end of this year.
While saviour siblings have been born before with the help of US laboratories, this is the first time scientists have carried out the entire process in the UK. The use of saviour siblings in medicine raises a number of ethical issues, with strong opinions both for and against the practice. Josephine Quintavalle, director of Comment on Reproductive Ethics told the BBC: '[Max] owes his life to his capacity to be of therapeutic use to his sick sister, otherwise he would not have been chosen in the first place. This is the big ethical problem'.
Simon Fishel, managing director of Care Fertility said: 'The ethical issues are in favour of doing this work. We are trying to save the life of a child and achieve a family without the enormous burden of a child with this disorder who would die'. Mrs Matthews also said she had no ethical problems with the treatment her family had received, 'Max is loved for being him and not for what he has done. He has completed our family and now I have a bubbly and healthy girl'.