Stem cell transplantation for inflammatory bowel disease: practical and ethical issues

Stem cell transplantation for inflammatory bowel disease: practical and ethical issues2][3][4][5][6][7] Recent case reports have raised the possibility that indications might be extended to inflammatory bowel disease. 8 9However, this would raise practical and ethical issues not encountered in other conditions.Inflammatory bowel disease activity involves a delicate and unpredictable balance between tolerance and immune reactivity to luminal factors that makes the outcome of stem cell transplantation diYcult to predict.Ethically, stem cell transplantation is more acceptable in some cases of systemic sclerosis where life expectancy is reduced or in multiple sclerosis where, additionally, there are few alternative eVective treatments.Neither of these principles apply to inflammatory bowel disease.