OBITUARY: Professor Alex Mowat

Alex Mowat had been Professor of Paediatric Hepatology at King's College Hospital, London, for the past five years, and his death represents a great loss to British paediatrics and to the many young patients he helped, both in Britain and throughout the world; he died while on a lecture tour in Chile.

Mowat was proud of his Scottish ancestry and his medical education in Aberdeen. The seeds of his brilliant academic career were sown during clinical appointments in the 1960s in Aberdeen, Hong Kong, and New York and matured in a research post in the Enzymology Department of the Rowett Research Institute, Aberdeen, and during a two-year Training Fellowship with Dr Irwin M. Arias in the Department of Medicine at the Albert Einstein College of Medicine, Yeshiva, New York. These posts gave Mowat an expertise in biochemistry, enzymology and hepatology which formed the basis of great clinical contributions to his chosen specialty of paediatric liver disease and in the care of children in general paediatric medicine. At the very early steps of his career, Alex Mowat met and married Ann Hunter, a continuous source of inspiration, support and love.

In 1970 Mowat was appointed to King's as Consultant Paediatrician and Paediatric Hepatologist, a post which was unique and a timely recognition of a completely new specialty. Although there had previously been no sustained academic interest in liver disorders in children in Britain, Mowat developed a first-class clinical unit for children who suffered with these rare conditions. The clinical work of the unit was backed up at all levels by research into causes and treatment; it needed staff from many disciplines and Mowat forged a team of hepatologists, paediatric and transplant surgeons, radiologists, pathologists, nurse specialists, dieticians and other specialists which had no equal at that time.

In 1986 the unit received official government recognition and funding, thus becoming the first supraregional centre for the treatment of children with liver disorders from all over Britain. The concentration of the children into one unit increased the knowledge and expertise in management and this was reflected in the improved results which formed the basis of more than 200 publications. Biliary atresia, portal hypertension and liver tumours were some of the conditions which were treated with results which were not surpassed in any centre in the world.

Mowat was supportive of the introduction of new techniques of treatment and this included the development of liver transplantation in children. His unit pioneered the development of auxiliary transplants and the successful introduction of the living-related programme - in which one of the parents gives part of their liver to be transplanted into the child - which has helped to ease the shortage of available organs in transplantation. Last year more than 560 children were admitted with life-threatening liver disorders and over 30 received liver transplants.

The international standing of the unit is remarkable and many of the research projects have been carried out in collaboration with university departments abroad. An example of the value of this work was the discovery of the key role of dietary copper in the causation of Indian Childhood cirrhosis, a finding which has led to the disappearance of the disease in parts of India in which this information has been made known.

The experience from King's was distilled by Mowat into his textbook Liver Disorders in Childhood (1979). The book reached its third edition in 1994 and is generally regarded as the reference book on the subject. Mowat has also been credited with raising the general awareness of his subject by introducing liver medicine into gastroenterological and general paediatric meetings. However his work was not restricted to the confines of the medical profession. In 1980 he encouraged parents of children attending the liver service at King's to develop an association which has become the Children's Liver Disease Foundation, a national charity. This organisation is dedicated to making the problems of children's liver disease more widely known, to improving outcome by funding research and to providing support for affected families. It has raised over pounds 3m.

Academic and clinical work produced other responsibilities for Mowat which he handled with skill. He was Head of the Academic Department of Child Health within the hospital and an examiner for London University and the Royal College of Physicians. He was also Honorary Consultant in Paediatrics to the Royal Air Force and Chairman of the Hospital Consultants' Committee.

Alex Mowat also had a full life outside his work. He loved his golf and taught many friends the art of whisky tasting.

Edward R. Howard and Giorgina Mieli-Vergani

Alexander Parker Mowat, paediatrician, hepatologist: born Cullen, Banffshire 5 April 1935; Consultant Paediatrician and Paediatric Hepatologist, King's College Hospital, London 1970-95, Head, Department of Child Health, King's College Hospital 1993-95; Clinical Teacher, London University 1970-95; Professor of Paediatric Hepatology, London University 1990-95, Senior Examiner in Paediatrics 1993-95; married 1961 Ann Hunter (two sons); died Santiago, Chile 11 November 1995.

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