Should People Who Abuse Alcohol Qualify for Liver Transplants?

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Three years ago, one of my uncles – a long-time alcoholic – was diagnosed with cirrhosis of the liver. He was told he didn’t qualify for a new one, so he continued to drink – all the way until his death a few short months later.

Alcoholism and Liver Disease

In 2015, more than 21,000 Americans died due to complications of Alcoholic Liver Disease (ALD), a spectrum of damage caused by over-consumption of alcohol.

A liver transplant is the only known cure, yet many ALD patients are unable to get on a list for one of these donated organs. This is because transplant hospitals commonly require patients waiting for a new liver to demonstrate six months of sobriety before they’re allowed to register. This not only gives doctors the opportunity to see if the patient’s liver restores function on its own in the absence of alcohol, but it also proves to them that the patient is serious about staying sober after the operation.

But deciding who receives one of these donated livers is complicated because there aren’t enough to go around. Unfortunately, there is a chronic shortage nationwide. In fact, 7,127 people received new livers in 2015, yet more than twice as many sick patients were on the national liver transplant waiting list as of mid-January that year. About 21 percent of those on the list were believed to have alcoholic cirrhosis, the most advanced form of ALD.

Who Gets to Decide?

This begs the question: Should people who are alcohol-dependent qualify for new livers, especially over those who’ve not ruined theirs with excessive drinking? This is a controversial issue, as some medical professionals and organ donors believe that “alcoholics are not deserving.” They feel ALD patients are “responsible for their illness,” are likely to resume drinking after the operation, or should suffer the repercussions of their past choices. Yet, others believe these patients are deserving of second chances – especially since a liver transplant can save those who’ve made a conscious decision to stop drinking once and for all.

However, selection committees in transplant programs around the country claim to be objective about who is placed on the national registry waiting list and try to not let their personal feelings get in the way. These committees, whose panels consist of professionals such as surgeons, pharmacists and social workers, weigh factors such as physical symptoms, substance-abuse history and whether or not patients have a strong support system, in order to determine whether they’re good candidates for transplants.

So what do you think? Are ALD patients deserving of new livers? Does the six-month rule make sense? Weigh in on this controversial issue below:

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