International Journal of Molecular Sciences Review Mitochondrial DNA Replacement Techniques to Prevent Human Mitochondrial Diseases Luis Sendra 1,2 , Alfredo García-Mares 2, María José Herrero 1,2,* and Salvador F. Aliño 1,2,3 1 Unidad de Farmacogenética, Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain;
[email protected] (L.S.);
[email protected] (S.F.A.) 2 Departamento de Farmacología, Facultad de Medicina, Universidad de Valencia, 46010 Valencia, Spain;
[email protected] 3 Unidad de Farmacología Clínica, Área del Medicamento, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain * Correspondence:
[email protected]; Tel.: +34-961-246-675 Abstract: Background: Mitochondrial DNA (mtDNA) diseases are a group of maternally inherited genetic disorders caused by a lack of energy production. Currently, mtDNA diseases have a poor prognosis and no known cure. The chance to have unaffected offspring with a genetic link is important for the affected families, and mitochondrial replacement techniques (MRTs) allow them to do so. MRTs consist of transferring the nuclear DNA from an oocyte with pathogenic mtDNA to an enucleated donor oocyte without pathogenic mtDNA. This paper aims to determine the efficacy, associated risks, and main ethical and legal issues related to MRTs. Methods: A bibliographic review was performed on the MEDLINE and Web of Science databases, along with searches for related clinical trials and news. Results: A total of 48 publications were included for review. Five MRT procedures were identified and their efficacy was compared. Three main risks associated with MRTs were discussed, and the ethical views and legal position of MRTs were reviewed.