How do u fell about a alcoholic receiving a liver transplant??

caroladybelle, BSN, RN · Sep 15, 2006

An alcoholic would never pass the screening to get on the UNOS list.

Mickey Mantle, who not only was an alcoholic but also had cancer.

David Crosby, who abused alcohol and every drug known to human kind.

chelli73 · Sep 15, 2006

I knew a guy from our neighborhood who had a kidney transplant and he was drinking and doing drugs as soon as he was "feeling better" from the surgery. YUCK. I don't know about excessive drinking being classified as a disease. It seems that the disease process begins AFTER the habit is formed. JMHO.

I will admit that I have little tolerance for alcoholics and/or drug addicts. SORRY.

caroladybelle, BSN, RN · Sep 15, 2006

I can't believe what you guys are saying!!! Not sure what the criteria is for this but good grief, put your personal opinions aside...sheesh!! Alcholism is a disease...it is not about someone drinking themselves into the sewer. Get educated!! Tsk tsk.

We are educated...and have actually graduated.

Livers for transplants are a rare commodity and are rationed. Unlike meds, where cost is the main limitation, transplantable organs are a very limited resource.

You have X number of patients waiting for the organ transplant, and a substantially smaller number of organs available. Who do you give the organ?

UNOS rates on the basis of need vs survivability, age, distance, compliance, and support system. This tends to eliminate recipients that have poorer compliance histories as they are less likely to survive for many reasons.

Are these rules fair??? No. I, as a 42 year old single female that toes the line, with no dependant children will be rated lower on a kidney list than an unmarried 21 year old female with 3 babies by different daddies, that destroyed her kidneys by noncompliance to DM meds, or by IV drug use, if she claims that she no longer does drugs.

Is that fair? No, but she is younger and has children.

A 67 year old father, that raised wonderful children to adulthood will be at the bottom of the heart transplant list (if considered at all), because he is over the "cutoff" age of 65. While the ne'er do well, with a criminal history that is 35 years old, and has young children will rate higher.

A person that has smoked their lungs, or drank their liver into oblivion - not easy to do, has already demonstrated a distinct lack of compliance with good health practices and are less likely to be successful, especially with the requirements of post transplant care.

Transplants are not a cakewalk...they are very stressful and require rigorous control of health. And transplanted organs are rare - especially lungs/heart/liver. UNOS owes it to the deceased to give this to the best future "custodian" in which it will be most useful and longer lasting.

It has nothing to do with the "morality" of drinking and everything with rarety of organs and longterm care of the organ by the recipient.

That said, money does alter the scenario, with celebrities having access to the ability to jet anywhere at a moments notice. If you have quicker access to a number of transplant centers, you can be listed for several locales, and if you are the best match, of appropriate condition (sick enough, but not too sick) that can get there within the required time frame, you will have better chances, sad but true. They are also more likely to have the "support" and financial resources for post transplant care.

RGN1 · Sep 15, 2006

Here in the UK a famous footballer - sorry - soccer player got a liver transplant. He was a known alcoholic & it caused quite a bit of controversy at the time.

He swore he was off the drink but kept being caught by the newspapers coming out of bars the worse for wear afterwards.

Anyhow, he did eventually kill his new liver off & he died. Most people here had some sympathy for his plight, he'd fought most of his adult life against this terrible addiction. It caused his illustrious sports careeer to be ended too prematurely, split up his marriage etc etc.

Others say he should never have been given the liver in the first place & that if he'd been Joe public he wouldn't have got the chance.

This topic will always divide. I think that if someone can prove they are really trying to make the changes they should be given a chance. In his case I don't think he was making the changes in all honesty so I feel sorry for the person who may have got the liver that went to him & maybe would have looked after it better.

However, I equally don't totally blame him, he had a disease & he couldn't fight it as well as some others manage to.

Now there's an "on the fence" answer for you!

LydiaNN · Sep 15, 2006

I can't believe what you guys are saying!!! Not sure what the criteria is for this but good grief, put your personal opinions aside...sheesh!! Alcholism is a disease...it is not about someone drinking themselves into the sewer. Get educated!! Tsk tsk.

We are educated. Have you not read that the guidelines for transplantation specifically consider the likelihood of success? It isn't about personal judgement, it is about using a very limited supply of lifesaving organs in a way that will ensure the greatest number of positive outcomes.

VickyRN, MSN, DNP, RN · Sep 15, 2006

Excellent post, caroladybelle.

Tweety, BSN, RN · Sep 15, 2006

I used to know a guy. I haven't seen him in a while, but he went into hepatic dysfunction not only from drinking but Hep C. The combination was deadly. He was in his 30s. He's 10 years post liver transplant and doing well and he's I think 12 years sober by now.

What bugs me is that he was a smoker. Obviously we can't tell transplanted persons how to live, but that seems disrespectful to the donor, even if he is sober now. Yes I am being judgemental.

I'm not sure I could decide who does and doesn't get a transplants.

Pat_Pat RN · Sep 15, 2006

My only hope is that "we" (the tax payers) have to pay for it too.

TheCommuter, BSN, RN · Sep 16, 2006

What bugs me is that he was a smoker. Obviously we can't tell transplanted persons how to live, but that seems disrespectful to the donor, even if he is sober now. Yes I am being judgemental.

My mother received a liver transplantation and, while she has never been an alcoholic, she continues to smoke. I, too, think it is disrespectful to the donor that someone continues to engage in an unhealthy vice after being given a second chance at life via this precious organ. However, it is my mother's life and I cannot tell her what to do with it. I just wish she would quit smoking.

Additionally, private insurance funded my mother's transplantation. No taxpayer dollars were involved.

Achoo!, LPN · Sep 16, 2006

At the University hospital near where I live, the patient has to be alcohol free for 6 months before they are put on the list.

Marie_LPN, RN, LPN, RN · Sep 19, 2006

Only 6 months. Sheesh.

Tweety, BSN, RN · Sep 19, 2006

My mother received a liver transplantation and, while she has never been an alcoholic, she continues to smoke. I, too, think it is disrespectful to the donor that someone continues to engage in an unhealthy vice after being given a second chance at life via this precious organ. However, it is my mother's life and I cannot tell her what to do with it. I just wish she would quit smoking.
Additionally, private insurance funded my mother's transplantation. No taxpayer dollars were involved.

Every time I saw my acquaintence light up I never said a word. I learned long ago never to rag a smoker about their smoking. It's a shame that after such a gift and 2nd shot at life your mom and my acquaintence smoke. That's just my opinion, judgemental as it is, but I know it's my opinion and my stuff, not theirs.

Quitting smoking is a process and perhaps during the operative time and recovery it's not the time. My acquaintenance however has had is liver for over a decade. Again, my stuff. Sorry. Back to the original topic. :)