Organ transplants hit record high

3 November 2010 Last updated at 20:08 ET By Jane Hughes Health correspondent, BBC News <!-- Embedding the video player --> <!-- This is the embedded player component -->

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Christine Meiklejohn describes what life is like while waiting for a kidney donation

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A record 3,706 organ transplants took place in the UK last year, an increase of 5% on the previous 12 months.

But NHS Blood and Transplant said there was still a long waiting list, with three people a day dying because of a lack of a suitable organ.

The refusal of relatives to allow donation often remains a key obstacle.

The doctors' union, the BMA, renewed its call for presumed consent, where all people are assumed to be willing to donate unless they choose to opt out.

There has been a steady increase in the number of organ donations in the past decade, and in 2008 a concerted effort began to boost the UK's rate, which lags behind those in most other European countries.

Many hospitals now have specialist nurses and transplant co-ordinators, and new systems which help identify potential donors and allow for an approach to families when death becomes likely.

The number of deceased donors reached 959 last year - some donating several organs - and there were 1,061 living donations.

'Reaping rewards'

There has also been an increase in the number of people volunteering to join the UK donor register, which hit the 17 million mark for the first time last year.

"We have made huge improvements to the way we work in hospitals," said Sally Johnson, director of Organ Donation and Transplantation at NHS Blood and Transplant (NHSBT).

"I'm glad these changes are reaping real rewards, with so many lives saved."

But there are still nearly 8,000 people on the waiting list for organ donations.

"Our work to promote the importance of organ donation must not stop as the need is increasing despite the rise in the number of transplants," said Ms Johnson.

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Sally Johnson, NHS Blood and Transplant: "Sadly there are still lots of people waiting"

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In 2008 the government said it wanted to see the number of donations increase 50% by 2013. NHSBT says it is on course to reach that target.

'Precious years'

At the same time ministers rejected a system of presumed consent, but some organisations believe this is still the best way to increase donation rates.

The BMA - British Medical Association - called for further debate on an "opt-out" system, and the British Heart Foundation said it would transform the number of available organs in one fell swoop.

"A heart transplant is a life-saving treatment for many patients and can give precious years to those who may otherwise have only weeks to live," said BHF policy director Beatrice Brooke.

The British Liver Trust said it was important not to be complacent.

The number of people on the liver transplant list increased 11% last year.

"Supply is simply not meeting demand, and liver disease rates show no sign of slowing down," said the trust's Sarah Matthews.

Public Health Minister Anne Milton called for more people to sign the donor register.

"We should all be aware of the difference we can make, or our families can make," she said. "A life lost can be a life saved."

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Drug &#39;could reduce stroke damage&#39;

3 November 2010 Last updated at 14:09 ET

Blocking a molecule which stops brain cells working properly after a stroke could help people recover better.

Californian scientists, writing in the journal Nature, said doing this in mice helped reverse the effects of a stroke.

A treatment based on this approach could be given days later, while conventional treatments need far quicker action.

The Stroke Association said far more testing would be needed on any new drug.

Strokes happen when an area of brain cells is starved of oxygen, due to a blocked or burst blood vessel.

Cells start to die in the affected area, and while nothing can bring these back, scientists know the cells immediately surrounding the damaged area play a crucial role in the ability of the brain to recover and compensate for the damage.

This process of "re-wiring", in which neighbouring brain cells make new connections to replace some of those lost during the stroke, can partly determine the degree of long-term disability some patients will suffer.

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Professor Anthony Rudd of St Thomas' Hospital explains what happens during and after a stroke

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The researchers, from the University of California in Los Angeles, found that a natural process within the surrounding brain cells appeared to be getting in the way of recovery.

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This is an interesting study, however it has only been tested on mice so far, and further research is needed to find out if it could be as effective in humans"

End Quote Dr Sharlin Ahmed Stroke Association

A build-up of a molecule called GABA appeared to dampen down activity in these cells at a time when they should be working hard to make new connections.

When strokes were induced in mice, giving them a drug which blocked the effects of this molecule appeared to improve their ability to recover movement.

Altering the genetic make-up of the mice to be less responsive to GABA produced similar results, adding weight to the theory.

The researchers believe that their work offers the prospect of a new type of drug to boost recovery in stroke patients.

Although trials in humans would still be some way off, the results in mice point to another significant advantage.

At present, strategies to limit stroke damage include giving 'clot-busting' drugs as quickly as possible after a stroke to try to limit the area of the brain affected.

This leads to a race against time to deliver the drug as soon as possible.

The Californian researchers found that blocking GABA produced the best results if done three days after the stroke - in fact, doing it immediately actually worsened stroke damage.

Dr Sharlin Ahmed, from the Stroke Association, said the need to give current treatments quickly, and the fact that not every stroke patient could receive them, meant that there was a "great need" for new ways to improve recovery and limit damage.

She added: "This is an interesting study, however it has only been tested on mice so far, and further research is needed to find out if it could be as effective in humans."

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Scans reveal autism brain secrets

3 November 2010 Last updated at 12:07 ET

Differences in the brain structure of people carrying an "autism gene" may offer clues to how the condition develops, say US scientists.

Scans revealed children carrying the gene variant appeared to have more nerve cell "connections" within the frontal lobe.

They had fewer connections between this and the rest of the brain, reported Science Translational Medicine journal.

Brain research has just begun to reveal autism's roots, a UK expert said.

One-third of the population carry the CNTNAP2 gene variant, so it does not guarantee that autism will develop, but just slightly increases the risk.

Different pathways

However, scientists at the University of California in Los Angeles believe it may influence the way the brain is "wired".

They used functional magnetic resonance imaging (fMRI) to look for communication between different brain regions, and to measure the strength of these connections.

They scanned the brains of 32 children as they performed learning-related tasks - half had autism, and half did not.

Regardless of their diagnosis, those carrying the CNTNAP2 variant had differences in the connections within the frontal lobe of the brain itself and between the frontal lobe and the rest of the brain.

Dr Ashley Scott-Van Zeeland, who led the research, said: "The front of the brain appears to talk mostly to itself - it doesn't communicate as much with other parts of the brain and lacks long-range connections to the back of the brain."

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The causes of autism are as yet unknown, but we do know there are likely to be many factors involved, so we hope this will contribute to our understanding of this complex condition"

End Quote Carol Povey National Autistic Society

The researchers also spotted differences in the "wiring" between the frontal lobe and the left and right sides of the brain.

In children with the version of the gene not linked to autism risk, the pathways were linked more strongly to the left side of the brain.

In those with the "risk variant", the pathways were different, linking the lobe strongly to both sides of the brain.

This, said the researchers, could explain why the gene variant had been linked to children who are slow in starting to talk.

Dr Scott-Van Zeeland said that if the gene variant did predict language problems, then it might be possible to design therapies which helped to "rebalance" the brain and encourage normal development.

Professor Margaret Esiri, a neuroscientist from Oxford University, said that researchers had so far "barely scratched the surface" of understanding the interplay between genes and brain development.

Her own research closely analyses a scarce supply of donated brains from both autistic and non-autistic adults and children to look for differences in structure and function.

She said: "If you understand these subtle differences, there may be ways of 'tweaking' them earlier in life, and bringing them back into a normal trajectory of development. Of course, this would be many years away."

Carol Povey, from the National Autistic Society, said the study was interesting because it began to link genes thought to be involved in autism to actual changes in brain function.

She said: "The causes of autism are as yet unknown, but we do know there are likely to be many factors involved, so we hope this will contribute to our understanding of this complex condition."

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Eye chip &#39;helps blind people see&#39;

2 November 2010 Last updated at 20:49 ET By Neil Bowdler Science reporter, BBC News <!-- Embedding the video player --> <!-- This is the embedded player component -->

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Miikka Terho is given the task of reading letters which together misspell his own name

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A man with an inherited form of blindness has been able to identify letters and a clock face using a pioneering implant, researchers say.

Miikka Terho, 46, from Finland, was fitted with an experimental chip behind his retina in Germany. Success was also reported in other patients.

The chip allows a patient to detect objects with their eyes, unlike a rival approach that uses an external camera.

Details of the work are in the journal Proceedings of the Royal Society B.

Professor Eberhart Zrenner, of Germany's University of Tuebingen, and colleagues at private company Retina Implant AG initially tested their sub-retinal chip on 11 people.

Some noticed no improvement as their condition was too advanced to benefit from the implant, but a majority were able to pick out bright objects, Prof Zrenner told the BBC.

However, it was only when the chip was placed further behind the retina, in the central macular area in three people, that they achieved the best results.

Two of these had lost their vision because of the inherited condition retinitis pigmentosa, or RP, the other because of a related inherited condition called choroideraemia.

RP leads to the progressive degeneration of cells in the eye's retina, resulting in night blindness, tunnel vision and then usually permanent blindness. The symptoms can begin from early childhood.

The best results were achieved with Mr Terho, who was able to recognise cutlery and a mug on a table, a clock face and discern seven different shades of grey. He was also able to move around a room independently and approach people.

In further tests he read large letters set out before him, including his name, which had been deliberately misspelled. He soon noticed it had been spelt in the same way as the Finnish racing driver Mika Hakkinnen.

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"Three or four days after the implantation, when everything was healed, I was like wow, there's activity," he told the BBC from his home in Finland.

"Right after that, if my eye hit the light, then I was able to see flashes, some activity which I hadn't had.

"Then day after day when we started working with it, practising, then I started seeing better and better all the time."

Soon Mr Terho was able to read letters by training his mind to bring the component lines that comprised the letters together.

The prototype implant has now been removed, but he has been promised an upgraded version soon. He says it can make a difference to his life.

"What I realised in those days was that it was such a great feeling to focus on something," he says.

"Even having a limited ability to see with the chip, it will be good for orientation, either walking somewhere or being able to see that something is before you even if you don't see all the tiny details of the object."

Electrical impulses

The chip works by converting light that enters the eye into electrical impulses which are fed into the optic nerve behind the eye.

It is externally powered and in the initial study was connected to a cable which protruded from the skin behind the ear to connect with a battery.

The team are now testing an upgrade in which the device is all contained beneath the skin, with power delivered though the skin via an external device that clips behind the ear.

This is by no means the only approach being taken by scientists to try to restore some visual ability to people with retinal dysfunction - what's called retinal dystrophy.

A rival chip by US-based Second Sight that sits on top of the retina has already been implanted in patients, but that technique requires the patient to be fitted with a camera fixed to a pair of glasses.

Charities gave the news of the latest work a cautious welcome.

David Head, of the British Retinitis Pigmentosa Society, said: "It's really fascinating work, but it doesn't restore vision. It rather gives people signals which help them to interpret."

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Baby post-mortem delay criticised

2 November 2010 Last updated at 21:07 ET

Thousands of parents are missing out on the chance to discover why their baby died during pregnancy or shortly after birth, say campaigners.

They say that although post-mortem examinations are usually offered, a combination of red tape and long waits mean that most parents say no.

The Royal College of Pathologists and charity Sands is calling for more government money to improve services.

More than 6,500 UK babies are stillborn or die shortly after birth each year.

While some of these cases are explained, many are not and hospitals can offer post-mortem examinations.

Unlike a coroner's post-mortem examination, parents have the right to refuse an examination.

Sands, which offers support to families who have suffered a stillbirth, says that far too few examinations are being carried out.

In 9% of cases, according to official figures, a post-mortem examination is never offered and in total 61% of perinatal deaths do not lead to one.

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Case study

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In 2008, Helen Thompson and her partner Steve chose a post-mortem examination after their baby, Jack, died in the womb at 35 weeks.

Although a harrowing experience, the results helped doctors look after Helen during her next pregnancy, she said. "At the time, we wanted answers so much - we definitely wanted to know."

There was a three-week wait for the results of the post-mortem examination. Helen said: "It was a terrible time, our heads were in a complete mess."

Although Jack had been delivered with the umbilical cord wrapped around his neck, the results suggested that the placenta had failed.

This meant that when Helen conceived again, she was given different care by doctors.

"I was given aspirin every day, and got extra scans to measure blood flow in the placenta." Her son Ethan was born earlier this year.

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The charity says the complexity of the process can also be off-putting for newly bereaved parents and the staff who are helping them.

Some consent forms used in maternity units were up to 25 pages long.

The strain on pathology services can also mean long delays before the post-mortem examination can take place, meaning it can be weeks before the body can be released for a funeral, the charity says.

One woman who spoke to Sands said she was told that because of a shortage of pathologists, there could be a delay of up to six months, and the body would have to be preserved in formalin in the meantime.

Neal Long, chief executive of Sands, said: "While the decision to consent to post-mortem is very much a personal one, high quality pathology and bereavement services are essential to ensure bereaved parents have informed choice, and are not needlessly discouraged from consenting."

He said that in some cases, the information gained at a post-mortem examination could make a big difference to the care available during future pregnancies.

Dr Phil Cox, a consultant perinatal pathologist at the Birmingham Women's Hospital, said post-mortem examination should be available in a "timely fashion" - but this was impossible in some areas.

"Even in the West Midlands, where we are relatively well-funded, the service is constantly very stretched, despite the currently low consent rate."

Currently, the cost of hospital post-mortem examinations are covered by NHS pathology services.

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Hopes over &#39;ending&#39; common cold

2 November 2010 Last updated at 05:49 ET <!-- Embedding the video player --> <!-- This is the embedded player component -->

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The research could be key in developing new anti-viral drugs

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Scientists say they have made a landmark discovery which could pave the way for new drugs to beat illnesses like the common cold.

Until now experts had thought that antibodies could only tackle viral infections by blocking or attacking viruses outside cells.

But work done by the Medical Research Council shows antibodies can pass into cells and fight viruses from within.

PNAS journal said the finding held promise for a new antiviral drugs.

The Cambridge scientists stressed that it would take years of work and testing to find new therapies, and said that the pathway they had discovered would not work on all viruses.

Fighting viruses

Some antiviral drugs are already available to help treat certain conditions, like HIV.

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But viruses remain mankind's biggest killer, responsible for twice as many deaths each year as cancer, and are among the hardest of all diseases to treat.

The new discovery by Dr Leo James and colleagues transforms the previous scientific understanding of our immunity to viral diseases like the common cold, 'winter vomiting' and gastroenteritis.

It shows that antibodies can enter cells and that once inside, they then trigger a response, led by a protein called TRIM21.

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Doctors have plenty of antibiotics to fight bacterial infections but few antiviral drugs"

End Quote Dr Leo James Lead researcher at the MRC in Cambridge

This protein pulls the virus into a disposal system used by the cell to get rid of unwanted material.

The researchers found this process happens quickly, usually before most viruses have chance to harm the cell.

And they discovered that increasing the amount of TRIM21 protein in cells makes this process even more effective, suggesting new ways of making better antiviral drugs.

Dr James said: "Doctors have plenty of antibiotics to fight bacterial infections but few antiviral drugs.

"Although these are early days, and we don't yet know whether all viruses are cleared by this mechanism, we are excited that our discoveries may open multiple avenues for developing new antiviral drugs."

Sir Greg Winter, deputy director of the MRC Laboratory of Molecular Biology, said: "This research is not only a leap in our understanding of how and where antibodies work, but more generally in our understanding of immunity and infection."

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