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submitted 1 week ago by NightOwl@lemmy.ca to c/canada@lemmy.ca
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[-] some_guy@lemmy.sdf.org 99 points 1 week ago

As an alcoholic, I initially agreed. Don't waste a liver on me. Then this:

Even pleas for a living liver transplant, with Allan offering to be her donor, were not entertained.

What the actual fuck.

[-] CommanderCloon@lemmy.ml 107 points 1 week ago

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, or she would die in operation.

Since she wasn't eligible, a partial transplant was just a death sentence.

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[-] Evotech@lemmy.world 13 points 1 week ago

Takes up valuable hospital times

[-] CommanderCloon@lemmy.ml 24 points 1 week ago

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.

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[-] ThirdWorldOrder@lemm.ee 73 points 1 week ago

Jesus Christ that’s fucked up. Only 36 too and stopped drinking… and had a willing living donor. What do you do in this situation when they won’t help you? Go down to Mexico?

[-] ricecake@sh.itjust.works 95 points 1 week ago* (last edited 1 week ago)

Well, stopped drinking when she got the diagnosis, not before, didn't comply with medical advice to stop drinking before hospitalization, and as they said in the article there are a lot of criteria for a living donation, and it's only an option if you otherwise qualify for a donation because of the possibility of rejection requiring an urgent transplant.

A different article said they were trying to raise funds to get the transplant done at an unspecified European hospital, so "yes". I think it's telling that they didn't go to the US, a north American country, or specify the country.
It's worth remembering that the only people who can talk freely are the people who were decided against and are talking about suing.

No one wanted her to die, but with organ transplants it's a case where you're more or less picking who will die. Phrasing it as being punished for bad behavior is unfair to the people who need to decide which people are likely enough to benefit, which isn't easy.

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[-] n2burns@lemmy.ca 56 points 1 week ago

Jesus Christ that’s fucked up. Only 36 too and stopped drinking…

From the article:

Amanda Huska died Aug. 15 after spending six months in an Oakville, Ont. hospital.

and:

Huska, he said, stopped drinking as soon as she was diagnosed with Alcohol Liver Disease on March 3

So that sounds like she was immediately admitted (which implies she was already very sick) and only was sober in the hospital. In my opinion, that doesn't qualify for "stopped drinking" and unfortunately she didn't get a chance to prove whether or not she was actually able to stop.

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[-] otter@lemmy.ca 22 points 1 week ago* (last edited 1 week ago)

I was reading through the article and I think the policy in question is this

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.

Also this

"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.

As for why that is, I'm not familiar. I've asked someone else and I'll edit in more if I learn more

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[-] swordgeek@lemmy.ca 40 points 1 week ago

There are more people who need transplants than there are organs, so the medical profession has to make decisions about who to deny. This was a reasonable decision, in my opinion.

[-] i_love_FFT@lemmy.ml 28 points 1 week ago

In Canada, drinking more than 3 drinks per week is medically considered "high alcohol use" for a woman... (6 for a man). This limit keeps getting lower year after year

If this can prevent you from getting organ transplants, then it encourages lying to your medical doctor about your current habits... That lady was not considered alcoholic, she just used alcohol in greater amount than the limit considered acceptable by doctors.

Latest stats show that almost 4 out of 5 people has exceeds that limit at some point in their life. This woman died only because she was honest with her doctor about her alcohol use. (Note that the article says her partner was a compatible donor but the system refused to accept him because she used alcohol. It's not about lacking donors.)

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[-] Ava@beehaw.org 22 points 1 week ago

I'd be inclined to agree, except that her partner wanted to donate HIS liver and was prohibited from doing so as a living donation due to the alcohol use determination.

[-] Default_Defect@midwest.social 35 points 1 week ago

Hi, transplanted organ recipient here (heart in my case), please be an organ donor if possible, thanks.

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[-] Mycatiskai@lemmy.ca 34 points 1 week ago

I'm quite torn on this issue, my sister donated her kidneys and liver when she died. On one hand people who need an organ, need an organ but on the other hand deceased persons organs are so rare that they should go to those with liver diseases they have no medical control over before those who are sick from an avoidable disorder.

I don't like to think of my sister's liver going to someone who would abuse it over someone who just happen to have a genetic liver issue. She lived a life too short bringing joy and education to many children, her final act saving others would be soured by someone wasting it.

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[-] queermunist@lemmy.ml 33 points 1 week ago

Maybe if donating organs was compulsory they wouldn't be so rare.

[-] Shou@lemmy.world 14 points 1 week ago

In my country, everyone is an organ donor unless they specifically opt out. Usually due to religion.

I've been seeing organ transportation ambulances near my city's hospital from time to time. It's weird to see, but a good thing.

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[-] Lumisal@lemmy.world 33 points 1 week ago

Since no one has mentioned it, USA has the same policy basically.

[-] johannesvanderwhales@lemmy.world 34 points 1 week ago

And for good reason, really. The supply of livers is too small to save everyone who needs them, so they give them to the people most likely to have a successful outcome. Basically every lived given to one person is sentencing another person to death. That's just reality with supply being what it is.

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[-] Gullible@sh.itjust.works 30 points 1 week ago

As grim as it might be, transplants are handled by apathetic, risk averse math and little else. Loose organs and surgeons are far from common.

[-] Fleur_@lemm.ee 12 points 1 week ago

Honestly I find that the opposite of grim, I wish more problems were solved in a cold and calculated way.

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[-] explodicle@sh.itjust.works 30 points 1 week ago

Well this was informative. I will now start lying to my doctor about my occasional alcohol use.

[-] exanime@lemmy.world 17 points 1 week ago

Or maybe read the article?

Occasional alcohol use won't put you in this situation (hopefully you'll never be in this situation for any reason)

However, of the reason you need a liver is that you wrecked your own with booze; you are unlikely to get another one

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[-] radicalautonomy@lemmy.world 25 points 1 week ago

My cousin was a raging alcoholic. He got clean, but not before he fucked his liver right up. I don't know if they even allowed him on the liver transplant list or not, but if he was, he was very low on it. He died in early 2015 at the age of 43.

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[-] honeybadger1417@lemmy.world 23 points 1 week ago

I donated a kidney to a friend earlier this year. The reason his kidneys failed wasn't anything he was at fault for, but even if it had been because of poor decisions he'd made in the past, I still would have given him one of mine. Because people deserve second chances. I can understand not wanting to give a recovering alcoholic a deceased donor's liver, when someone else could receive that liver, instead. But this woman's partner was a match and was willing to donate to her. What's the harm in that? That isn't a liver that could have gone to someone else who needed it. It's a donation that would have either gone to her or no one else. No one could have lost out of the donation had been carried out. This was just cruelty, and now someone is dead. And for what? Because there's a 15% chance (according to studies the article mentioned) that she might have started drinking again???

[-] Breadhax0r@lemmy.world 17 points 1 week ago

It's not super clear, but the article makes it sound like if a partial graft from a live donor fails, then the recipient is automatically fast tracked for a new transplant from a deceased donor.

If that's the case then maybe policy should be changed in the case of alcohol abuse.

[-] CommanderCloon@lemmy.ml 14 points 1 week ago

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.

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[-] Kecessa@sh.itjust.works 12 points 1 week ago

Surgeon time is precious as well.

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[-] Ulrich_the_Old@lemmy.ca 22 points 1 week ago

If you are going to make alcohol consumption a bar to a liver transplant without making alcohol illegal you should all go fuck yourselves. You had a drink and you should die should not be a thing.

[-] LustyArgonianMana@lemmy.world 22 points 1 week ago* (last edited 1 week ago)

This isn't what happened though. She was addicted to alcohol, per her partner, got diagnosed with needing a new liver, she immediately quit alcohol, and they denied her anyway even though quite a bit of time had passed while she was sober. I am unaware if her liver disease was because of the previous regular alcohol use. It wasn't just 1 drink though.

Yes, organ donation is messed up. I met a girl dying in hospice once. She needed a new kidney. Genetic stuff, and then when she was 15 she tried to kill herself with Tylenol. She got her first transplant before the suicide attempt. She was denied a second one due to the suicide attempt itself. There are only so many organs in the world. She died in agony in hospice, young and covered in calcium deposits.

We punish substance use and mental health so harshly in this country. No one deserves the death penalty for previous substance use, especially for alcohol which is ancient af. It's horrible she was denied when there was a liver already available.

[-] Yaztromo@lemmy.world 17 points 1 week ago

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.

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[-] ZC3rr0r@lemmy.ca 16 points 1 week ago

It's incredibly sad to hear someone die of a preventable cause this young, but I can also somewhat relate with the people who reviewed her application.

If a living donor wouldn't have been sufficient, they've now created two patients where they previously had one, and without improving the primary patient's condition. It makes sense that a donor organ from a deceased donor would be preferable.

That said, the current requirement for the patient to meet deceased donor standards for transplantation to be eligible to use a willing living donor make no sense. Both situations should have their own unique criteria, given that a living donor situation involves different risks for both the patient and the donor than a deceased donor situation would incur.

Ultimately this whole situation boils down to a scarcity situation though. If we want to solve this, it will require more people to register themselves as a donor and a review of the eligibility criteria as soon as more donors are available.

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this post was submitted on 08 Sep 2024
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