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Monday, June 25, 2012

Should Sobriety Be Prerequisite To Receive A Liver Transplant?

The New England Journal of Medicine
The New England Journal of Medicine (Photo credit: Wikipedia)
Should sobriety be a prerequisite for a person to receive a liver transplant? Unless you or a loved one is in need of a life-saving liver transplant this probably is not a question that you have considered. The reason we are talking about this question today is that once again a young person's inability to stay sober has been the deciding factor for rejecting him to receive a liver transplant.

The latest article also comes from the United Kingdom. The headline reads "Man dies from binge-drinking at age of just 22, three years after he's rejected for transplant."  His name was Gareth Anderson; his liver failure began when he was 19. His devastated father explains how out of control Gareth's life has been for the last three years: kidney failure, jail, intensive care, binge-drinking, arrested for assault. Two weeks ago, Gareth died in hospital surrounded by his family. According to the article: "Gareth Anderson is thought to be one of the youngest victims of chronic alcohol abuse in the U.K."

In November 2011 the Huffington Post reported on a study that was published in the New England Journal of Medicine. The study was conducted in France and found:

"...the vast majority of the patients who got a liver without the wait stopped drinking after their surgery and were sober years later. The study involved patients who were suffering from alcohol-related hepatitis so severe that they were unlikely to survive a six-month delay."

This is a heated debate. Those involved include the very sick in need of a liver transplant (both alcoholics and non-alcoholics), the medical community, the medical research community, affected families, insurance companies...the list goes on. As Dr. Robert S. Brown Jr., transplant director of New York -Presbyterian Hospital/Columbia University Medical Center while agreeing it may be time to reconsider the six-month rule he went on to tell the Huffington Post:

 "The challenge of this paper [French study] is to come up with better ways, both to treat alcoholism as a disease and to predict who will succeed with transplantation."

Not all liver transplant applicants are alcoholics, many suffer from liver disease stemming from obesity, drug use, hepatitis C resulting from reasons other than drug use. But it would appear that only alcoholics must meet a "special" life style change prerequisite in order to qualify for a transplant. 

Your comments are welcome.
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