The prospects for in utero stem cell transplantation

In utero transplantation of haematopoietic stem cells into the foetus, early in gestation, offers a new approach to genetic disorders. Immunological naivete and the sterile uterine environment are perfect conditions for transplantation, so that even mismatched cells will engraft. There have been notable successes world-wide, although numbers are small, which gives encouragement to further work directed at means to enhance and sustain engraftment in a foetal recipient. For example, stem cells for transplant can be obtained from various sources but these have different properties that can be exploited for therapy in specific disorders. However, some disorders may not be amenable to in utero transplantation and there is need to achieve consensus in order to ensure that the procedure is used appropriately, for the benefit of all.