Intrauterine transplantation

Westgren, Magnus

doi:10.1182/blood-2009-01-199851

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…Thus, a consensus has been difficult to reach and fetal transplantation has not been widely adopted, despite the fact that successful cases treated in utero had outcomes comparable with the best reported with postnatal transplantation48.…”

Section: Discussionmentioning

confidence: 99%

In Utero Haematopoietic Stem Cell Transplantation (Iuhsct)

Renda¹,

Maggio²

2009

Medit J Hemat Infect Dis

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In utero haematopoietic stem cell transplantation (IUHSCT) is a non-myeloablative approach for the prenatal treatment of genetic disorders. However, in target disorders, where there is not a selective advantage for donor cells, a useful donor-cell chimerism has not been achieved. There are three possible barriers to engraftment following IUHSCT: limited space in the fetus due to host-cell competition; the large number of donor cells needed, and the immunological asset of recipient.

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Section: Discussionmentioning

confidence: 99%

In Utero Haematopoietic Stem Cell Transplantation (Iuhsct)

Renda¹,

Maggio²

2009

Medit J Hemat Infect Dis

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Fetal Medicine and Treatment

Westgren

2011

Pediatric Clinical Pharmacology

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Fetal medicine covers a broad spectrum of conditions that can be diagnosed before birth. Different disorders will require different treatment strategies and there is often an important ontogenetic aspect on how and when treatment can be implemented. Due to the limited availability there is a general lack of knowledge on how pharmacotherapy can be provided in the most efficient way. Until recently most knowledge about how different drugs are transferred and metabolized in the human fetus is based on very limited observational studies on concentrations of drugs in fetal blood and other fetal compartments. It might be that the rapid development of other non-invasive methods for fetal diagnostics such as isolation of fetal DNA and RNA in maternal serum, NMR imaging and other techniques could in the future be explored in fetal pharmacotherapy. Introduction of new treatment strategies are often based on extrapolation from experience in neonates and adults. However some fetal conditions are very specific for this time period in life. This especially entails disturbances in development as malformations, early growth restriction and several congenital disorders. Here it might be required to introduce new treatment strategies without any previous experience in humans. Example of this ethical dilemma is gene therapy for lung growth in severe cases of diaphragmatic hernia and early growth restriction. The risk-benefit issues need to be discussed in all these alternatives. However, it is likely that the concept of the human fetus as a potential patient is still in its infancy and with an improved understanding about fetal patho-physiology there will be a continued need for better knowledge of pharmacotherapy during this crucial time period in life.

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Intrauterine transplantation

Cited by 2 publications

References 5 publications

In Utero Haematopoietic Stem Cell Transplantation (Iuhsct)

In Utero Haematopoietic Stem Cell Transplantation (Iuhsct)

Fetal Medicine and Treatment

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