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June 2001

Ethics and Human Fetal Retinal Pigment Epithelium Transplantation

Arch Ophthalmol. 2001;119(6):899-900. doi:10.1001/archopht.119.6.899

AGE-RELATED MACULAR degeneration (ARMD) is the major cause of legal blindness in elderly persons in Western civilization.1 Histological studies document progressive damage to the retinal pigment epithelium(RPE), the Bruch membrane, and the choriocapillaris, giving rise to secondary retinal photoreceptor atrophy and vision loss.2,3 While progress in the treatment of this disease is being made, current therapy is far from satisfactory. Using a novel approach, researchers have replaced diseased host RPE with healthy donor RPE cells4 as a means of preserving or improving retinal function. Various sources of donor RPE cells have been identified, including human fetal RPE.5 Human fetal tissue has special biologic properties, including low antigenicity, capacity for differentiation, and suitability for transplantation. However, controversy exists regarding the use of human fetal tissue, and little mention is made in the ophthalmic literature concerning the ethical implications of human fetal RPE transplantation. Irrespective of the ultimate success or failure of this technique as a treatment for ARMD, examination of the ethical debate surrounding human fetal tissue transplantation is both fruitful and instructive.

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