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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Who will win the Copeland by-election?

Labour face a tricky task in holding onto the seat. 

Too close to call, neck-and-neck, down to the wire. Pick your cliché for a close-run thing, and that’s what the parties are saying about Copeland.

No governing party has won a seat in a by-election since 1982, and the seat has been Labour-held since 1935, but the circumstances could scarcely be more favourable to the Conservative Party. They are well ahead in the opinion polls and Labour’s electoral coalition is badly split over Brexit.

To add to the discomfort, Jeremy Corbyn, the Labour leader, has a long history of opposing nuclear power, though he has sounded a more supportive note since becoming leader. Sellafield is the main employer there, so regardless of the national picture, that would be an added complication.

Given the competing pressures from the Liberal Democrats on one side and the Conservatives and Ukip on the other, Labour should expect significant erosion in the 42 per cent of the vote they got in 2015. To win, all the Conservatives have to do is tread water. And it's worth noting that so far in this parliament, the results in by-elections have been what you'd expect according to the current state of the parties in the polls - which would mean you'd back Labour to win Stoke but the Tories to win Coepland. 

That Theresa May has visited the seat attests to the closeness. Privately, neither party can be confident of winning. For the Conservatives, that makes it worth putting Theresa May, currently the most popular politician in Britain if the polls are to be believed, into the fray, because what have they got to lose? For the Labour leadership, there is nothing to "win" if they hold a seat in opposition, but there is something to lose if they cannot hold it and Corbyn has visited in the final week. 

What is keeping Labour competitive is the state of the health service in Cumbria. If West Cumberland, the hospital, is closed, then residents will face a two hour drive to the nearest hospital.

The local “success regime” is the cause of significant public opposition. "There are a lot of people who are angry about Jeremy, angry about Trident [the submarines are made nearby]," says one MP, "But they also understand that if they vote Labour they will not be bringing in a government that closes Sellafield but they can send a message about West Cumberland [the hospital that is under threat of closure]."

So Labour have reason to be more cheerful than the bookmakers are concerned. The outcome will come down to what the question that voters are asking when they vote is: if it is nuclear power, the Tories will win. If it is healthcare, Labour will triumph.

In that, May’s visit has probably helped Labour on balance. She could have decisively shifted the contest by making a commitment to keep West Cumberland open and to secure the future of the Moorside nuclear plant. But she did neither, and instead that meant that the local newspaper splashed on her refusal to confirm that the hospital was safe. Which, in a close election, may well be the difference as far as winning and losing are concerned. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.