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

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Murder by numbers: the legacy of the Grenfell Tower fire

It is difficult to refute the reality of suffering when the death toll is still being reckoned.

How do we measure human malice? Sometimes it’s all too easy. This summer, British cities are struggling through the aftermath of successive terrorist attacks and hate crimes. The Manchester bombing. The Westminster Bridge murders. The London Bridge atrocity. The attack on people outside the Finsbury Park Mosque in north London and on other mosques. The unidentified young men who are still at large in the capital after spraying acid in the faces of passers-by, mutilating them.

In Britain, we are commendably resilient about these things. Returning to London after some time away, I found my spirits lifted by an issue of the London Evening Standard magazine that celebrated the ordinary people who stepped in to help after these atrocities. The paramedics who worked through the night. The Romanian chef who offered shelter in his bakery. The football fan who took on the London Bridge terrorists, screaming, “Fuck you, I’m Millwall!” The student housing co-ordinator who rushed to organise board for the victims of the inferno at the Grenfell Tower and their families.

Wait. Hold on a second. One of these things is not like the others. The Grenfell Tower disaster, in which at least 80 people died, was not a terrorist or malicious attack. It was the result of years of callous council decisions and underinvestment in social housing. On 14 June, entire families burned alive in their homes partly because, it is alleged, the Royal Borough of Kensington and Chelsea would not pay the extra £5,000 or so for fire-resistant cladding. Nor could it find the cash, despite a budget surplus, to instal proper sprinkler systems on the rotting interior of the building.

Kensington and Chelsea is a Tory borough that, in cash terms, cares very little for poorer citizens who are unlikely to vote the right way. In 2014, while the Grenfell Tower residents were refused basic maintenance, the council handed out £100 rebates to its top-rate taxpayers, boasting of its record of “consistently delivering greater efficiencies while improving services”. Some of those efficiencies had names, and parents, and children.

This is a different sort of depravity altogether. It’s depravity with plausible deniability, right up until the point at which deniability goes up in flames. Borrowing from Friedrich Engels, John McDonnell described the Grenfell Tower disaster as “social murder”. The shadow chancellor and sometime Jack Russell of the parliamentary left has never been known for his delicate phrasing.

Naturally, the Tory press queued up to condemn McDonnell – not because he was wrong but because he was indiscreet. “There’s a long history in this country of the concept of social murder,” he said, “where decisions are made with no regard to the consequences… and as a result of that people have suffered.”

It is difficult to refute the reality of that suffering when the death toll is still being reckoned from the towering tombstone that now blights the west London skyline.” As the philosopher Hannah Arendt wrote, “The sad truth is that most evil is done by people who never make up their minds to be good or evil.”

Market austerity is no less brutal for being bloodless, calculating, an ideology of measuring human worth in pennies and making cuts that only indirectly slice into skin and bone. Redistributing large sums of money from the poor to the rich is not simply an abstract moral infraction: it kills. It shortens lives and blights millions more. Usually, it does so in a monstrously phlegmatic manner: the pensioners who die early of preventable diseases, the teenagers who drop out of education, the disabled people left to suffer the symptoms of physical and mental illness with nobody to care for them, the thousands who have died on the waiting lists for state benefits that they are perfectly entitled to, the parents whose pride disintegrates as they watch their children go to school hungry.

We are not encouraged to measure the human cost of austerity in this way, even though there are many people in back offices making exactly these sorts of calculations. This year, when researchers from the Journal of the Royal Society of Medicine claimed that “relentless cuts” to the health service could explain as many as 30,000 “excess deaths” in England and Wales in 2015, the government denounced this as “a triumph of personal bias over research”, which, however you slice it, is a callous prep school debater’s response to the reality of 30,000 fresh graves.

There is a species of evil in which an individual allows the dark and yammering corners of his mind to direct him to put a blade in a bystander’s belly, or a bomb in a bustling crowd of teenage girls. That sort of monstrosity is as easy to identify as it is mercifully rare, though frighteningly less rare than it was in less febrile times. But there is another sort of evil that seldom makes the headlines. This comes about when someone sits down with a calculator and works out how much it will cost to protect and nurture human life, deducts that from the cost of a tax rebate for local landowners or a nice night at the opera, then comes up with a figure. It’s an ordinary sort of evil, and it has become routine and automated in the austerity years. It is a sort of evil, in the words of Terry Pratchett, that “begins when you begin to treat people as things”. 

The Grenfell Tower disaster was the hellish evidence of the consequences of fiscal ruthlessness that nobody could look away from. Claims that it could not have been predicted were shot down by the victims. The residents’ association wrote on its campaign website after years of begging the council to improve living conditions: “It is a truly terrifying thought but the Grenfell Action Group firmly believe that only a catastrophic event will expose the ineptitude and incompetence of our landlord.”

That catastrophic event has happened, and the ordinary British response to tragedy – brave, mannered dignity – is inappropriate. When the Grenfell inquiry launches next month, it is incumbent on every citizen to call for answers and to call this kind of travesty by its name: murder by numbers.

Laurie Penny is a contributing editor to the New Statesman. She is the author of five books, most recently Unspeakable Things.

This article first appeared in the 20 July 2017 issue of the New Statesman, The new world disorder