Mirococept could double life of transplant organs

Doctors are to begin a trial of a drug treatment that could double the time transplanted organs survive in the body.

The 20-minute procedure effectively coats donor organs in a protective shield that stops them being rejected by the patient's immune system.

The treatment is expected to prolong the time that organs remain healthy in patients' bodies and also increase their shelf-life, so they can be stored for longer or transported further before being used.

If the treatment works, it could ease the burden on organ transplant services, which face an increasing gap between the supply and demand for donor organs.

Last year, 8,000 people were on the waiting list for kidney transplants in Britain, but only 2,500 operations took place. In the past year, 448 patients have died while waiting for a donor organ.

People who receive transplants must take drugs to suppress their immune systems, but the body still reacts enough to cause transplants to fail sooner than they should.

A healthy transplanted kidney lasts on average only 10 years, around one third of the time it should last. Organs such as hearts and livers fail even sooner. The consequence is that patients who have had one donor organ often need another.

The new treatment, developed by researchers at King's College London, is based on the defence mechanism healthy organs use to shield themselves from the immune system.

Protein molecules that dot the surface of organs keep the immune system in check and prevent it from launching an attack. These proteins are lost when organs are removed from the body, handled and stored on ice.

The King's team found a way to manufacture these proteins in the laboratory and produced a drug called mirococept, which can be fed into the organ with a drip.

Studies suggest the procedure could extend the life of an implanted kidney by around seven years. "If the treatment goes to plan, it can be expected to almost double the life of a graft," said Steven Sacks, director of the MRC Centre for Transplantation.

The scientists believe the treatment will also extend the shelf-life of donor organs, increasing the time they survive outside the body from no more than 24 hours to several days. This could reduce wastage and double the number of organs that work properly once they are transplanted, doctors said. In early tests, only a fifth of organs worked properly after being stored on ice for 16 hours, compared with 50% of those treated with mirococept.

A recent pilot study of the treatment on 16 patients found it was safe to use. The group now plan to recruit more than 300 patients for a trial that will take place at transplant centres across the country.

The trial is expected to begin next year and will investigate how much drug organs need to be treated with to protect them. If it is successful, doctors will need to do a final, much larger trial to study how much longer treated donor organs survive in patients. Professor Sacks said the treatment could be available in hospitals in five years.

Patients who receive donated organs treated with mirococept will still need to take drugs to suppress their immune systems, but doctors said an aim of their research was to see if the use of current drugs, which can increase a patient's risk of cancer, can be reduced.

drive from www.guardian.co.uk

Britain's Spartan Kingship

This Monday 'Dave and Nick', as the PM and his deputy are to be known, gave a press conference backing their ambitions for the next five years. This government would be “a radical, reforming government where it needs to be and a source of reassurance and stability at a time of great uncertainty,” said Nick Clegg. He may not have known it, but he was delivering a Spartan manifesto.

Most equate Spartans, not altogether wrongly, with the impossibly chiselled warriors from graphic shock-fest 300. Yet Sparta's awesome army was propped up by a rigid governmental system, at the front of which stood not one but two kings. The kings presided over a privy council of 28 elders, five of which, the ephors, decided policy and made sure each king had the state's best interest at heart.

It worked perfectly. While enemies quarrelled over affairs Sparta's two kings could do it all at once. Neither king could outweigh his opposite's veto, so decisions were swift and final. It meant both could wage war separately, or govern back home. This autocratic stability was at odds with the Athenians in particular, whom Sparta would defeat in 404BC, who obsessed over rhetoric and debate.

Did having two kings create tension? You bet. “Two royal houses – twice the potential for the rows that all monarchies are prone to,” points out historian Bettany Hughes in her recent Ancient Worlds series. “The Spartans explained this arrangement by claiming that their kings were direct descendants of the great-great grandsons of Herakles, the strongman of Greek myth.”

Nick and Dave's ancestry are well-documented: Clegg the grandson of Russian nobility; Cameron the blue-blooded offspring of a Baronet's daughter. Neither can claim to be the son of a god, yet. And they can tick rowing off the list having called each other 'arrogant' and 'a joke', among other pleasantries, during the election campaign.

Eventually Sparta's dual kingship would prevent it spreading its wings - “Some historians call this stability 'political stagnation',” says History Walker Herald - and by the end of Sparta's renaissance its two kings were little more than ceremonial generals pandering to radical councillors. With Britain facing economic turmoil and a pair of unpopular wars, Nick and Dave's partnership might not last beyond the next election. But if their coalition is questioned in future, maybe a line from Gerard Butler's Leonidas would be apt: “Madness? This is Sparta!”

drive from www.independent.co.uk