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Rethinking the Rules of Organ Transplants

Posted Feb 28 2010 12:00am
 
Have you ever watched a person die? If death is expected, it can be beautiful. If it's abrupt, it can be deeply disturbing. But if it's predictable and preventable, but is not prevented as a matter of policy, it's torturous.
I'm talking about organ transplantation, or more specifically, patients who need an organ transplant but don't qualify for the surgery. Hundreds, if not thousands, of patients die annually while waiting on the organ transplant list. I suspect many hundreds more die because they never make it to the list in the first place. Given the scarcity of organs available for transplantation and the implications of the surgery itself, transplant centers are incredibly choosy about who the recipients are. They take into account the patient's other medical problems, likelihood to survive the surgery and how desperately the transplant is needed. They also factor in proof of abstinence from alcohol. These criteria may seem straightforward, but enforcing them can lead to some very painful situations.
Take, for example, the case I witnessed of a middle-aged housewife* with four school-aged children who alleviated her daytime boredom by drinking a couple, or eight, vodka tonics. She went to rehab, but too late -- her liver had begun to shut down. Most transplant programs insist that recipients be sober for a minimum of six months. By four months of sobriety, however, her situation was critical; she wouldn't live another month, much less two. Did I mention she had a willing living-related donor ready to go?
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