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

GETTY
Show Hide image

The view from Google Earth is magnificent - but there's a problem

Google Earth is spectacular - but it can give a misleading impression of the planet and the threats we face from climate change. 

 

Google Earth wants you to “get lost” in its updated interactive map. Collaborations with new media partners mean you can now climb Mount Everest, swim with sharks or visit Afghanistan with Zari the purple muppet. No, really:


Source: Google Earth

Yet as Trump slashes support for the science behind satellite imaging, is Google’s emphasis on spectacle leading us down the wrong path?

Google Earth's new look all starts well enough. Opening the new site on your browser takes you to an image of a blue earth floating through the blackness of space. Back in the 1970s, similar images taken from the Apollo space missions helped kickstart the modern environmental movement. As the astronomer Sir Fred Hoyle put it: “Once a photograph of the Earth, taken from the outside, is available, a new idea as powerful as any in history will be let loose.”


Source: GETTY and Google Earth

And it gets better. Enter a destination in the search bar and you are greeted with the option to link directly out to the Wikipedia page: nerds of the world, rejoice! 

A guided tour from NASAearth is also on hand for anyone whose nerdery is in need of a prompt: “Geostationary satellites in geosynchronous orbits. Greenhouse gases and global warming. Glaciers... going, going, gone,” says the Bob Dylan-esque entry on its "ABCs from Space".

You can then choose to orbit your landmark of choice in 3D. And let’s face it - who doesn’t want to glide around the top of Mont Blanc, pretending to be an eagle? It’s almost as good as the BBC’s actual eagle-cam

But then it hits you. This is no soaring eagle, buffeted by wind currents and having to constantly adjust its flightpath in the face of real-world obstacles. This is a world surveyed at a safe and sanitising distance. Tourism for the Trump age – focused on providing “a consumption experience”. Certainly it is the opposite of “getting lost”.

In fact if anything has been lost or downplayed, it is the principles of scientific enquiry. The program is littered with human choices. Local versions of Google Maps, for instance, have shown different national borders depending on where in the world you log in. And while new, open-data imagery from America's Landsat 8 program is helping bring many regions up to date, other high-resolution imagery comes from commercial providers, such as Digital Globe. And as this Google 'help' page implies, there are issues of time-lag to face. 

You can’t even be sure what you’re looking at still exists. In 2015, Bolivia’s second largest lake vanished - a combination of climate change, El Nino, and irrigation withdrawal caused 2,700 square kilometres of water to evaporate into a dry salt pan. (It has not recovered, and seems unlikely to do so.) Yet on the new version of Google Earth the lake is still a healthy green:


Source: GoogleEarth

The much lauded film clips from the BBC’s Planet Earth II are similarly short on context. As I've argued before, David Attenborough's latest TV series did little to explain the stories behind the spectacle – there was no mention, for instance, of the arctic anthrax outbreak which caused thousands of reindeer to be culled, nor the role of climate change in worsening locust swarms. 

Finally, the new update actually shows you less of the world than it did before. Gone is the “Historical Imagery” tool that allowed you to see how a place had changed through time. Now, the Citadel of Aleppo in Syria is only visible as a bombed-out ruin. A surreal street-view reveals two women cheerily taking a selfie – with debris all around and their legs spliced out of shot:


Source: GoogleEarth

So why do these omissions matter? Because they take users further away from the evidence-based approach of earth science. It turns out that satellite images on their own are of limited use when it comes to quantifying change. Instead researchers must turn the raw pixels into numbers, which can then variously represent everything from forests to cities, glaciers and farms.

As Dr France Gerard at the UK’s Centre for Hydrology and Ecology explains, this process enables us to live in a better managed environment – be that by measuring air pollution or the impact of fertiliser on soil. The centre's landcover map, for instance, has been mapping British land use since 1990. Similar methods allow Sam Lavender’s company to provide Ugandans with a Drought and Flood Mitigation service, as part of the UK Space Agency’s International Partnership Programme.

Sadly, the need for public engagement has never been more urgent. Brexit and austerity have cast doubt over important projects in the UK. While in Donald Trump’s America, funds for earth monitoring are set to be slashed. Two missions already under the knife are PACE, a spacecraft set to track global ocean health, and CLARREO, which would have produced highly accurate climate records. Trump has also called for the earth-viewing instruments on the DSCOVR satellite to be turned off. Phil Larson, a former space advisor to President Obama, describes this decision as “baffling”.

So what can be done to reverse this trend? Experts I spoke to believe that collaboration is key. With government programs being squeezed, the earth monitoring industry may come to rely increasingly on the trend towards smaller, commercial satellites. These are great for increasing the quantity of data available but their accuracy needs to be constantly checked against the data from the larger and more reliable state-launched equipment.

There’s also still more data out there to share. As Bronwyn Agrios from Astro Digital points out, many countries have been gathering region-specific data – which could, in future, be made open source. “The neat thing about space is that there’s no border,” she concludes.

To help this process, Google Earth could do far more to raise public awareness of the science behind its special effects. Yet at least in one way it is already on the right path: its own new range of collaborations is impressively large. As well as the BBC, you can take interactive tours with The Ocean Agency, the Wildscreen Arkive, and the Jane Goodall Institute – all of whom put conservation up front. The Goodall journey to Tanzania’s Gombe National Park even describes the use of satellite imagery to measure conservation success.

 

More links with other citizen science projects around the world could turn the program into something truly ground-breaking. If it can incorporate these, then desktop-tourism may yet save the planet from Trump. 

India Bourke is an environment writer and editorial assistant at the New Statesman.

0800 7318496