Who Gets A New Liver?

Should a person’s past and/or current behavior dictate whether or not they can receive an organ transplant? If you are thinking that that is a complex question, you are right! A large percentage of people who are in need of a transplant have done things in their life that damaged their organs, such as smoking cigarettes and drinking alcohol. Since organs are limited and extremely valuable, it may be easy for some to argue that people who have willingly harmed their health, may be less deserving of a transplant than people who have lived health conscious lifestyles. What’s more, many people who are in need of an organ are still using harmful substances.

In the United States, transplant centers have different policies when it comes to potential liver recipients - how their use of cigarettes, drugs or alcohol affects their chances of getting a transplant. The question of liver transplantation in patients with a history of addictive disorders was covered by panelists at the American Association for the Study of Liver Diseases (AASLD) annual Liver Meeting, MD Magazine reports. The panelists consisted of transplant experts.

“You don’t want to waste a liver, but you don’t want to deny a patient a life-saving therapy either, just because he’s a smoker,” said David Riech of Hahnemann University Hospital in Philadelphia. “A lot of people who need liver transplants are smokers.” 

Panelist Michael Lucey, MD, chief of the division of gastroenterology and hepatology at the University of Wisconsin School of Medicine in Madison, WI surveyed 134 transplant centers in the United States, according to the article. Lucey received responses from 42 of them, and they account for about half of all the livers transplanted in the US

Dr. Lucey found that very few centers require patients to be in a smoking cessation program. 27 centers required a six-month period of abstinence from opiates. The majority of centers were found to have no policy regarding marijuana use, which the experts agreed that marijuana’s effect on the liver was understudied, the article reports.

When it comes to alcohol, he found that:

• 24 centers require a set period of abstinence from alcohol.
• 15 centers said “it depends.”
• Only one center said “no.”

Naturally, providing a new liver to someone with a history of alcohol abuse raises some questions. There is always a chance that the patient will relapse, potentially harming the new liver. Although, there is no way to quantify a person’s risk of relapsing, the article writes.

There is not enough information on the impact of various addictions on transplants, according to the panel.