General Question

luigirovatti's avatar

Do you know that, in the case of a liver transplant, if you don't take 6 months of abstinence before being admitted to an hospital, you could REALLY die for Alcoholic Liver Disease?

Asked by luigirovatti (1124points) 1 month ago

This criterion is used by many transplant centers, and it’s known as the ’‘6 month rule’’. And, this, of course, is addressed to those who don’t know. But I do like those who’d like to comment on that.

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21 Answers

luigirovatti's avatar

In many cases people with alcoholic liver disese have less than 6 months to live.

ARE_you_kidding_me's avatar

For good reason. If you can’t stop for six months you probably won’t after the transplant.

On the flip side many who abstain for six months won’t need the transplant after that.

luigirovatti's avatar

@ARE_you_kidding_me: What do you mean, stop? Stop what? Drinking, you mean? What if, for those people, who realize they’re going to die, the liver was a second chance? Not for being perfect, but for doing good?

ARE_you_kidding_me's avatar

Yeah drinking. Of course it’s a second chance. Thing is though some who can’t stop will continue to drink after the transplant. That’s why there is the six month rule.

luigirovatti's avatar

@ARE_you_kidding_me: Why the alcoholic liver disease must happen twice? Maybe they’ll drink more, maybe less. What I think is, it’s it’s not up to us to judge.

ARE_you_kidding_me's avatar

Only once. Why waste a liver on someone who is just going to wreck it again.

JLeslie's avatar

What do you mean you could really die? If you aren’t dry, then you aren’t getting the liver, because someone “more deserving” gets it.

stanleybmanly's avatar

I’ll keep that in mind since Trump might drive me to drink.

anniereborn's avatar

I believe no alcoholic should get a liver transplant unless they have been clean and sober for a good ten years. My father was a severe alcoholic. He died from liver failure. No way a transplant would have helped him. Seriously give it to someone who will treat it like the gift it is.

luigirovatti's avatar

I think that you are a bit cynical. Maybe, when you’ll drink and’ll have ALD, I’ll wait for the moment when you look yourselves at the mirror and wait yourselves to die.

anniereborn's avatar

@luigirovatti I watched my father die. That was plenty. No transplant would have saved him.
Also….we all have to die someday. It’s part of life.

luigirovatti's avatar

All I’m talking about is that, if you are a doctor, you’ll surely have a patient in your hospital who needs a liver. You also might just happen to have a liver that needs a patient. I don’t think it’s that difficult, it’s that simple, if you consider the patient. Rules are secondary. And, if you rebut that there are hundreds of patients with needs of a liver, the problem is, YOU have to make the decision, and YOU have not hundreds of patients in your hospital (presuming those who read this are doctors). You’ll have one, a few at the most, not hundreds. And, you have a chance to cure them right now. If you don’t, you’re just as responsible, and you’ll feel just as responsible, as the six-month-rule, probably put in place by the board of directors of the relative hospital.

jca2's avatar

@luigirovatti: Organ donations are flown to other hospitals around the country. They’re not limited to only the hospital of the donor.

With a very long waiting list for livers, and not many donors, there have to be some criteria and qualifications in order to receive one. If someone is going to get the rare and precious gift of a liver, and then screw it up, what would be the incentive for the hospital to give them one? To choose someone who is going to ruin the donation over someone who is going to try their best to live a good, long life would make no sense.

luigirovatti's avatar

@jca2: I don’t make judgments. If you make them, I hope for you that you don’t make them on your own. You can try to talk to the patient, and tell them the alternatives. But, anyway, when the doctor makes this decision, (s)he doesn’t make it out of the blue: (s)he understands that their decision results from a way of thinking “thought”, and applied, with possible equal devastating results, long before the transplant. So it’s not really up to us to judge outside the patient’s interests.

KNOWITALL's avatar

@Luigiirovatti Supply and demand, theres not enough for everyone so they can be picky. Just follow the rules. Thats not a judgement, just how it works.

jca2's avatar

@luigirovatti: It’s not my decision, it’s up to the hospital, and they have to have some criteria, as explained by @KNOWITALL. If you have an issue with it, you should write to each hospital in the US care of their Ethics Board. Tell them how you feel.

JLeslie's avatar

@luigirovatti I don’t know if you’re in America, but this is what little I know about it in America.

Organ coordinators fly organs all over the country as mentioned above. When you need an organ you go into a national database.

There is such a thing as specifically naming someone to receive an organ if you are doing a live donation, maybe even in death for some organs, that I don’t know about specifically, but a good amount of donations for organs are unplanned deaths, and their organs go to the next person on the list who is a match, and the organ can arrive in time. Big storm in the area that a flight can’t take off in literally can mean a person can’t get an organ from a faraway state that if weather was good they could have had it. Usually, this is avoided by keeping the “dead” person on life support, but unpredictable things happen. All these details are monitored to ensure a transplant will be successful.

People can move up the list depending on urgency, but you have to qualify and meet the standards.

There is judgement used on who is most likely to benefit from the organ, it is like playing God in a way. That’s how it works. The government regulates it to some extent, and the United Network of Organ Sharing (UNOS) and serious ethical questions are scrutinized regarding who gets priority on the list.

Most liver failure happens over time, although there is such a thing as very rapid, acute, liver failure.

If a person’s liver function is going down, and the person is an alcoholic, and wants the option of a liver transplant, it’s time to stop drinking. If they stop, they might never need the transplant, even better.

There is no way to make it completely fair. There aren’t enough livers for everyone who needs one.

I used to know an organ coordinator, and he was constantly flying organs to different cities and states. Mostly kidneys.

JLeslie's avatar

Here is a video on how UNOS develops policies.

https://unos.org/policy/how-we-develop-policy/

Same website talking about liver criteria.

https://unos.org/policy/liver-policy-updates/

zenvelo's avatar

@luigirovatti Consider this very common scenario:

Patient A is dying from Hepatitis C that he was infected with twenty years ago. He needs a liver.
Patient B is dying of cirrhosis caused by ongoing alcoholic drinking without any periods of sobriety. Which one gets a transplant?

I have a friend who died before he could get a liver transplant. He had been an artisanal printer/bookmaker at a small literary press, well known in his field. He contracted liver disease from exposure to the chemicals used in printing. Would you have chosen an active alcoholic that wouldn’t take care of a donated liver over someone who had liver disease from chemical exposure?

jca2's avatar

If you click on this link, they talk about liver transplantation and alcoholism. It’s toward the bottom of the article. These are not rules that are made by anybody on Fluther, so arguing with Jellies on Fluther is kind of pointless, @luigirovatti.

Read on:

https://transplant.surgery.ucsf.edu/conditions--procedures/alcoholic-liver-disease.aspx

Darth_Algar's avatar

No, sorry, but if you’ve destroyed your own liver from drinking and you’re not willing to stay sober for even a few months then why should you get that liver over someone who is willing, or over someone who’s in liver failure because they innocently contracted Hepatitis C years ago?

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