Woman who was denied a liver transplant, after review highlighted alcohol use, has died

If you keep reading it gives a reason why this is a requirement. Now whether you agree with the doctors or not is up to you but there is at least a reason for this.

But doctors say that people with severe liver disease from alcohol use may need more than just a partial living liver donation to thrive.

"The sicker someone is, the more they benefit from getting an entire liver from a deceased donor, as opposed to part of the liver from a living donor," said Dr. Saumya Jayakumar, a liver specialist in Edmonton and an Associate Professor in the Faculty of Medicine & Dentistry at the University of Alberta.

"On the off chance their (living) liver doesn't work, they urgently get listed for a deceased donor," said Jayakumar. "We need to make sure that everyone who is a candidate for a living donor is also a candidate for a donor graft as well, " she added.

From this, the reasoning appear to be this: there is a high risk that the living liver transplant will not take. In this case the patient may be at risk of dying instantly and thus need another liver transplant. Since the candidate doesn't not qualify for this other transplant, in the case where the transplant does not take, the patient will die instantly. This is in contrast with the patient being terminally ill however given time to live out the remainder of their life.

Question: are there any countries where this is allowed? Would they have been able to go abroad and do this operation?

As someone else already pointed out, if the transplant from the living donor failed or had complications, now you have two people that need livers. It puts a healthy person at risk for a very low chance of a positive outcome. If they were paying out of their own pocket, then I'd say sure, go ahead, blow your own money on it, risk your own life and health. But they aren't.

I don't think renewable excludes it from being limited.

IIRC, there are ongoing experiments with organs are being grown in cloned animals; the animal is slaughtered, and the organ is harvested. Maybe someday they'll be more readily available and renewable than they are now.

...At least for the wealthy that can afford to have farms of cloned animals.

They said it was viable in the early stages, and with a decent success rate. Just not the success rate they wanted, and for some daft reasons you need to be eligible for a full transplant from a dead patient to get a partial transplant from a living donor. Makes no sense.

Has lesser liver performance? What? Do you understand how a living transplant works? You both regrow a full liver after the procedure, because livers are so regenerative you can make a full one from less than half. This makes no sense to me.

Also she quit for 5 months after she found out she had liver failure.

If a surgeon refused to let me save the life of the one person in the world i love then they wouldn't be able to save any more lives after that so add that to your heartless calculations...

No. A partial liver transplant wasn't viable for someone this sick, so when the partial transplant failed, they would have to resort to a full transplant from a dead donor. But she wasn't eligible, so a partial transplant was just a death sentence.

You've gotten a lot of downvotes but rather than doing that I want to explain to you why your position here is flawed.

First think of every lifestyle activity whether it be food, motorcycle riding, music, etc. Now consider that there are some activities that are statistically safer than others.

If we took your position to the point of being law why would we stop at food lifestyle choices? Why not just any risky lifestyle choices? Eventually you end up with a society where individuals have less choice and freedom and are constantly obligated to live the safest possible lives.

You and I both know that isn't a desirable outcome. We should be empowering people to live the lives they choose and encouraging them to be healthy, not punishing them for make the "wrong" choice.

What a shitty attitude.

If were going to have a public health system, people should be required to take care of themselves

On the face of it, this sounds sensible. But, thinking more deeply, who should decide the required amount of care a person ought to take? Ideas about what it means to 'take care of yourself' are varied. And consider that some citizens of this country are simply unable to take the same personal health decisions that others have the privilege to take without a second thought.

What you're talking about here isn't a public system. A healthcare system that only serves certain chosen people is not public in any meaningful sense.

A public healthcare system is imperfect on the whole, but on average, when funded and administered properly, is structured to apportion care based on need, instead of the profit motive. I think that's worthwhile, and the right thing for a society to do from a moral standpoint.

Thats a dark road to tread.

An example,

no alchol consumption is safe, so using your line of thinking you'd need to argue that anyone who partakes of alcohol at any anytime would fall under that line of thinking

https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health

Processed red meats simailary, especially those treated with nitrites, so those eating bacon, ham etc shouldn't be entitled to public heath care under your reasoning

https://www.cancercouncil.com.au/1in3cancers/lifestyle-choices-and-cancer/red-meat-processed-meat-and-cancer/

Or are those things ok becase you do them ?

On the upside, now you've excluded 95% of the population, public healthcare will be cheap :)

Contra to most peoples thinking, if you're concerned about public healthcare costs, you should "encourage" obesiety and smoking, they all die early, most health care coats are associated with healthy people in their old age. See here

https://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748884.html

Adults are stupid and greedy, we all are.

So I drink more pop than I should. Why should I have to pay more for my healthcare than my buddy who had a habit of timing running green lights as soon as they turned green. That isn't illegal, either, yet it's very risky behavior. It didn't work out for him just one time, and he nearly died. Why should taxpayers have to pay for him?

The answer is because the vast majority of us engage in risky behavior, or just have the bad taste of passing on our poor genetics to the next generation, and the social cost for penalizing people for not agreeing with societal norms are too high. This includes drug use, even legal ones like alcohol. Sure, don't spend limited resources such as donated livers on people who aren't willing to make the lifestyle changes required to make it worthwhile, because someone else will probably have to die for that to happen. But if we could make new livers and the price was reasonable, I wouldn't even be against that.

Until there is a diet that has long term success for a majority of its users I don't think this mindset is healthy or realistic.

"According to the latest weight-loss research, 95% of dieters end up regaining the weight they lost within two years. Calorie-restricting diets are often successful at helping people lose weight, but they’re very unsuccessful at helping people maintain that weight loss." source

Type 2 diabetes has a stronger link to family history and lineage than type 1, and studies of twins have shown that genetics play a very strong role in the development of type 2 diabetes.

https://diabetes.org/about-diabetes/genetics-diabetes#:~:text=Type 2 diabetes has a,also depends on environmental factors.

Now that you know you were cruel and wrong about diabetes, what do you have to say? What about the type 2 diabetics that have a perfect lifestyle and still have type 2 diabetes?

I didn’t catch the part where she relapsed after diagnosis. For fucks sake how much was this lady drinking to get liver failure at 38?

I believe this is FALSE:

[she] relapsed into drinking while on the transplant list,

Where does it say this? I reread it 3 times. That's a huge part of the story and not one you should just make up!

How much do you need to drink to get ALD at 36?

I read the whole article and never saw that

It's taxed the way it is, because the only drug that kills more than booze are cigarettes.

Those taxes also go to help innocent people who are harmed in crimes that are often related to alcohol, like domestic violence, assault, and auto-incidents, also things like uttering threats and mischief.

Their boyfriend volunteered as a live donor. They weren't asking to be put on the general register.

That's not true. Living donors can donate part of their liver.

Doctor here who has referred patients for transplant. No. You must be six months sober to be eligible for the transplant list. There’s so few livers to go around, they need to be sure the recipient isn’t going to just break the next one.

It’s rare to suddenly need a liver; they usually take months to fail and this gives the patient and doctor months of notice to try treating the failure first (including lifestyle changes and meds) before getting sick enough to go apply for a transplant.

She literally quit when she was told she had a failing liver that could not recover. Just to be clear, there is absolutely no way in hell that she didn't know she was on the way to killing her liver with her drinking because there are a plethora of signs long before you get to the point where alcohol has destroyed your liver beyond its own ability to repair itself. (Which is incredibly prodigious. The liver is the single most regenerative organ in the human body)

So forgive me if I'm skeptical that she really would have stopped being an alcoholic after she received a liver transplant.

IMO this was a tragedy of her own making and the money and effort in transplanting a liver would have been a complete waste. (Even one offered by her SO.) Especially when there is such a deficit of available organs and the surgeons who do the transplanting are needed for patients who aren't likely to go back on the sauce 6 months later.

In most places, if they've been clean for 6 - 12 months, they are no longer considered alcoholic in terms of transplantation. Similar to Canada

I completely agree that alcoholism is a disease, and as with any other disease, we have to look at the survivability if she got the transplant.

Let's be honest, while the article tries to be favourable to the patient, you can piece together the facts and see that her odds weren't good. While she's been sober since she got the diagnosis, it appears she was immediately hospitalised which tells us she was in very rough shape and has only been sober while in the hospital. Even if she was able to stay sober, it looks like the odds with a partial transplant aren't great.

Some could consider it a mental disorder.

Compared to an autoimmune disease that attacks organs and glands, I'd think the autoimmune patient should be top of the list. Probably good that I'm not on death panels though.

It is, or at the very least is a symptom of another one. I have all kinds of addiction issues which is why I must be super careful in my life. I am a former alcoholic who used to drink nearly every day from basically after work until I was too tired to keep going. I also have ADHD and possibly ASD (the latter not officially diagnosed as of now). There seems to be some evidence that those can play a role in addiction.

This woman died only because she was honest with her doctor about her alcohol use

No, and it even says so in the article

She quit about 5 months before her death when transplants require 6-12 months of sobriety. She was drinking regularly with the fucked up liver before that diagnosis, and liver damage isn't something that just suddenly appears.

She kept drinking despite what would have been intense cramping pain and a slow death, thats why she was denied (addiction) and ultimately died

Note that the article says her partner was a compatible donor but the system refused to accept him because she used alcohol

And as the article also says it's incredibly dangerous for someone to get a live-donor transplant when they're in bad shape like she was, as failure of that means they'll need to let her die on-table or transplant a good dead one into her (which she was denied for, due to her drinking)

It's sad, but this woman died to alcohol abuse, pure and simple

That's total bullshit. As a IT professional I have a nightly drink after work for self medication. Never two. Just one.

The only genuine hint to the real reason of the refusal was "minimal abstinence outside of hospital".

Let me ask you bud, if you needed a liver transplant to continue living, would you have even one drink per week, or would you just quit completely?

Very biased article.

Plus, regardless of her husband being compatible, it still costs the state tens of thousands for the operation. In no way would it be ethical to put a new liver in someone who refuses to completely abstain from alcohol.

Like killing disabled people because it's cheaper, farming slaves to provide cheap labour, that sort of thing?

There a good reason we tend to prefer the more humane and emotionally guided solutions over the mathematically most efficient.

There should be no opt out, even for religion. No I do not respect your customs as much as I respect someone else's life.

Imagine how many matching organs are just left to rot in the ground.

He'd been drinking since he was a teenager, and he'd sometimes get blackout drunk, getting arrested for public intoxication, etc.

I didn't see in the article if she self-reported alcohol use, or was tested. I'm responding to the comments here about self-reporting.

Same for all the people who eat nuts and get hospitalized as well, pull the plug right? I mean come on, they are lesser humans as we stand on our pedestals and look down on them. /S

Genetics play a huge role in liver diseases. 85% of liver replacements don't come from alcohol. Alcohol in sure is bad for you, but it really is a high horse scenario.

In case I get liver failure for some reason other than drinking, but get disqualified for answering incorrectly.

The policy isn't there just to be extra nice, it's because otherwise the patient dies without a liver.

Since she was too sick for a partial liver transplant, and not eligible for a dead donor full liver transplant, she would have just died.

It might seem cruel but the same is done for a lot of other procedures; if the chance of you dying in surgery is way too high, doctors won't take the risk, they're not executioners.

It's not a moral judgement about her alcoholism, the same would have been true if she had a cancer no surgeon would take on.

In the article, it shows that the hospital spent significantly more slowly letting her die than the average cost of the transplant.

So let the free market sort out the organ redistribution problem!

Did you bother to read the article?

Did you? Her liver was so far gone, doctors did lot believe a partial transplant would work

Yes, I read the article three times over, trying to chase down false info someone posted in here. His offer is irrelevant. The prognosis was not good enough for him to donate. They only included it in the article for the melodrama. It's nothing more than an "I would die for her!" moment. Well, I'm glad the medical board did not condone assisting him with suicide.

It's not just acceptable, it's encouraged by the province to keep people from rage quitting their lives here.

It's horrible she was denied when there was a liver already available.

Any full cadaver liver that could have gone to this woman didn’t get thrown into the garbage — it went to someone else who would have died without it.

As for the living donor liver her boyfriend offered, even though he was a match her level of liver failure likely meant that the partial liver her boyfriend could have donated wouldn’t have been successful. Living donors still need a liver for themselves, and we each only have one full liver — so the best they could have done is given her half a liver. Her condition was too poor for this to have a likely positive outcome, which was why this was also denied.

It sucks, but there aren’t enough donor livers for everyone who needs one. The cadaver liver she was denied however would have gone on to save the life of someone else you’re not hearing about in the press — someone else who may have died without it.

If the unfairness of it all upsets you that much, then make sure you’ve signed your organ donor card, and make sure your family members know and understand your desire to be an organ donor. And encourage the people you know to do the same. This is only a problem because there aren’t enough donor livers for everyone — when you have n livers, at best you can save n lives — and thus having a larger number of donor livers allows for more lives to be saved, with fewer qualifications.

From my limited knowledge organ donation criteria are horribly restrictive on a personal scale but unfortunately make sense on the macro scale. Organs are such a scarce resource that as I understand there's no other option.

This girl's death was undoubtedly a tragedy, but as fucked up it's to say if she lived someone else would probably die in a similar agony. Was she treated fairly - I don't know, can we make this system better - I unfortunately also don't know.

We punish substance use and mental health so harshly in this country

It's not punishment, any chronic illness will make someone ineligible for an organ transplant. It's not saying it's that person's fault, it's a situation of "2 people need this organ, which ever you choose the other will die in agony, one is more likely to live twice as long as the other."

I believe that's an established procedure. Both the donor and the recipient regrow full livers from the portion they have. You can only donate once though because of how the new liver tissue is structured. I believe the arteries in the new one aren't in the same place.

Edit: if you read the article it actually tells you her boyfriend was willing to be a live donor.

maybe this is a joke going over my head but you just described a liver transplant. what blew my mind was learning that they don't take the old liver out, they just squish the new one(the healthy liver sliver if you will) in and let it do it's thing

Artificial kidneys are in the test phases. Not sure when they’ll enter trials but it’s very complicated.

So some rough numbers I found from places online for rough estimates. Also, the link the article has for bed costs is actually to a study on liver transplant costs.

On average, 25 days in hospital between pre/post transplant. Of that, seems like a few days (varies by person) is in ICU. So thats 50 days of beds for the two of them, with say a week of combined ICU time.

Plus two surgeries - the article only takes an average cost of liver transplants, which is not indicative of a second surgery needed for a living donor transplant.

That puts the cost up to ~240,000-300,000. That cost is close enough that I can see it not being a factor for the decision.

Right? Like I would donate my liver to my kid, or my spouse, without even questioning it.

But if the doctor told me they can't have it (for some reason other than incompatibility), and they died? Fuck them. I'd de-register as an organ donor out of spite.

The fact that people are down voting you for saying in essence “my body, my choice”, is ironic for lemmy.

Doctors are cops. Pass it along

The system didn't fail, it worked as intended. If but mid 30s you've destroyed your liver with your alcohol addiction, it's almost guaranteed you'll slide back.

Recipients can't drink ever, and have to take meds for life. She was not a good candidate for a transplant.

didn't need the editing master here