Medical futurology is no excuse for the UK's organ failures

A mouse with a human liver is extraordinary indeed, but we should do better with what science has provided.

We can create a mouse with a human liver. So, no longer any need to face up to the tricky subject of organ donation, right? Wrong. One of the dangers of such achievements is that we begin to think that a solution to the organ crisis is just around the corner.

The Japanese mouse-human chimera involved taking adult stem cells from human skin and chemically inducing them to return to their “pluripotent” state, where they can become any kind of cell. Further treatment guided them to take the form of liver cells, which were then grafted into the mouse. There, they connected to the blood vessels and formed into a functioning human liver.

The work built on an idea first put forward by the US geneticists Tim Townes and Thomas Ryan in 2000. They spotted that knocking out certain genes and inserting genetic material from an afflicted patient allowed you to rear an animal whose heart, liver, pancreas or blood or skin cells were human – that were genetically matched to the recipient and were in every way perfect for transplantation.

By coincidence, Townes and Ryan submitted their patent application on the day after Sally Slater was discharged from a hospital in Newcastle. Slater, aged six, had undergone an emergency heart transplant after a virus attacked her cardiac tissue. Her donor was a recently deceased, middle-aged woman whose family came forward to help after Slater’s father issued an emotional appeal through the national media.

Every year in the UK, a hundred or so families go the other way and overrule the wishes of a deceased relative who had wanted to donate his or her organs. In the decade that it might take for the Japanese success to make any headway into patient treatment, more than a thousand families could dash the hopes of the desperately ill. That’s in this country alone, where more than 7,000 people are waiting for transplants. A thousand of them will die this year because of a lack of organs. Slater, now a thriving 19-year-old with a 62-year-old heart, has been vocal and active in drawing attention to the shortfall, encouraging more people to sign up for organ donation.

Things might get a little better after the 2 July decision by the Welsh Assembly to adopt “presumed consent” for organ donation. After 2015, people in Wales who don’t want their organs recycled will have to sign the opt-out register. Somewhat perversely, organs from Wales will be available to patients in the rest of the UK, which remains opt-in after a 2008 review concluded that opt-out was unlikely to increase the number of donated organs and risked reducing their availability IN THE FRAME by undermining trust in the medical profession.

Britain has one of the highest refusal rates in Europe, with half of all families denying organs if the deceased’s wishes are not known. In some ways this is understandable. It is only 45 years since the first UK liver transplant and 30 since our first heart-and-lung transplant. That is a very short time, in human terms, in which to contemplate changes to our death rituals.

Nonetheless, we should do better with what science has provided – regardless of what is coming. A mouse with a human liver is extraordinary indeed. But scientists have also made great strides in learning how to perform transplants, how to suppress the immune system’s rejection of foreign tissue and how to care for those who have gone through such traumatic procedures.

It would be a terrible shame if the advances of stem-cell research were to provide any further excuse for refusing to save a life.

Japanese scientists have grown human liver cells in mice. Photograph: Getty Images

Michael Brooks holds a PhD in quantum physics. He writes a weekly science column for the New Statesman, and his most recent book is At the Edge of Uncertainty: 11 Discoveries Taking Science by Surprise.

This article first appeared in the 15 July 2013 issue of the New Statesman, The New Machiavelli

Photo: Getty
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What Labour's plotters are thinking

The ground may have shifted underneath Jeremy Corbyn's feet, at least as far as the rules on nominations are concerned. 

Jeremy Corbyn’s leadership has been rocked by seven resignations from his shadow cabinet, as the attempt to remove the Labour leader gathers speed and pace.

I’m told there will be more to come. What’s going on?

As I’ve written before, the big problem for Labour’s Corbynsceptics is that Corbyn won big among party members in September and his support has, if anything increased since then. Although a lot of ink was wasted over fears of “entryism” which at the outside probably contributed about a percentage point to Corbyn’s 40-point landslide, it is “exitism”  - the exodus of anti-Corbynite members and their replacement with his supporters that is shifting the party towards its left flank.

Added to that is the unhelpfully vague wording of Labour’s constitution. It is clear that Corbyn’s challengers would need to collect 50 signatures from Labour MPs and MEPs to trigger a leadership challenge, a hurdle that the plotters are confident of hopping. It is less clear whether Corbyn himself would have to do so.

But what appears to have happened is that Iain McNicol, the party’s general secretary, has received legal advice that he should not put Corbyn on the ballot paper unless the parliamentary Labour party does so – advice that he is willing to put his job on the line to follow. McNicol believes that the NEC – which has a fragile Corbynite majority on some issues but not on all – will back him up on this matter. (Significantly, at time of writing, none of the three frontbenchers who hold NEC posts, which are in the gift of the shadow cabinet not the party’s leader, have resigned.)

McNicol himself is currently at Glastonbury. Also on his way back from that music festival is Tom Watson, the deputy leader, whose political protégés include Gloria DePiero, who resigned earlier today. Stiffening the resolve of Labour MPs that they can pull this off and survive the rage of the membership is a motion of no confidence in Jeremy Corbyn passed by Wrexham constituency Labour party. The MP there is Ian Lucas, a respected MP from the party’s right, who is now on the backbenches but resigned from Tony Blair’s government in 2006 after Blair refused to set out his departure date.  That coup, of course, was organised by Tom Watson.

Watson is respected by Labour’s general secretaries, who are publicly supportive of Corbyn but many of whom would privately prefer to see the end of him. Crucially, they are even more opposed to John McDonnell, who has been a reliable ally to their leftwing opponents in internal elections.

As for party members, having called around this morning there is certainly some movement away from Corbyn, partly due to the Vice documentary and also due to the referendum campaign. My impression, however, is that the candidate they are looking for – someone who could have much of Corbyn’s politics but with greater political nous and the ability to bring together more of the PLP – doesn’t exist in the parliamentary party. There are some lower-ranked members of the 2010 and 2015 intakes who might fit the bill, but their time is far from ripe. It's also not clear to me how significant that movement away is in percentage terms - Corbyn won by 40 points and was 19 points clear of needing a second round, so his capacity to survive erosion is strong. 

Significantly, within the parliamentary party's three anti-Corbyn tendencies, “the let him fail and strike once” and the "we're stuck with him, keep quiet and do other things" factions are currently recessional and the “strike and strike until he gives up” faction is ascendant, adding to the pressure on the leadership, at least temporarily. The prospect of what may be a winnable election post-Brexit with a different leader - as one MP said to me, "Angela [Eagle] is not that good but she is good enough [should Brexit trigger a recession] - has Corbynsceptics less inclined to write off the next election. 

At the start of the year, I thought that no attempt to replace Corbyn before the election would work. That's still my “central forecast” – but a bet that looked more reliable than a ISA now looks rather shaky.

Stephen Bush is special correspondent at the New Statesman. He usually writes about politics.