this post was submitted on 08 Sep 2024
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Woman who was denied a liver transplant, after review highlighted alcohol use, has died (www.ctvnews.ca)
submitted 2 months ago by [email protected] to c/[email protected]
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[–] [email protected] 48 points 2 months ago* (last edited 2 months ago) (3 children)

This was my initial opinion until I read the whole article.

"I got my blood tested, I had MRI scans, I had a CT scan, I had ultrasound and blood compatibility test with her. I was a match," said Allan.

Transplant guidelines in Ontario and much of Canada require patients with ALD to first qualify for a deceased donor liver. If they don't meet that criteria, they aren't considered for a living liver transplant, even if one is available.

Her partner was a willing, compatible donor, wanted to give her his liver and was prevented from doing so. So yes, this is a cruel take.

[–] [email protected] 75 points 2 months ago* (last edited 2 months ago) (2 children)

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.

[–] [email protected] 14 points 2 months ago (1 children)

I guess then the question should be is that worse than definitely dying now, and where does this cross into the patient having the right to request their own treatment?

I will always defer medical guidance to medical professionals, I know nothing in comparison to them.

[–] [email protected] 34 points 2 months ago* (last edited 2 months ago) (1 children)

It is worse.

If the living partial liver doesn't take hold, it dies off and becomes necrotic, and would need another surgery to take out or it'll become necrotic and they'll die of sepsis. It's also unlikely they'd survive such second surgery, due to the already existing liver failure + first surgery trauma.

In this case, you'd be asking doctors to directly kill the patient in a more painful way for a very tiny chance that it may save them, on top of if they do survive, assuming they don't relapse into alcoholism and die anyway. All while technically injuring someone else (the live donor).

[–] [email protected] 11 points 2 months ago

Thank you, that does sound like an awful way to die.

I try to never assume I’m smarter than others for seeing the “obvious” path. I had a coworker in another department once call me out for saying “why don’t you just” and it’s stuck with me since.

[–] [email protected] 12 points 2 months ago (1 children)

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

[–] [email protected] 3 points 2 months ago* (last edited 2 months ago)

I don't know enough to be able to answer your question.

However, even if you did find a country you could do this in, you'd have to deal with the cost and time required to travel there, consult with the local doctors, get the surgery scheduled, perform the surgery, and remain for post-op care - all of which would be likely out of their own pocket.

Canada has universal single payer health care system and I have no idea how they deal with medical procedures done outside the country. I highly doubt they would cover unless they were on private insurance that allowed it.

Not everyone has the means to do what you suggest unfortunately.

[–] [email protected] 12 points 2 months ago

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.