NEWS : 25.2.10 - Dying drug addict refused second liver transplant

[Crankinit]

Ahh - there's the rub. You are confusing correlation and causation. She used drugs after her transplant, and her transplanted liver is still failing. That doesn't mean that the drug use caused that failure - you are just assuming that. Liver transplants just don't last that long, as I said above. Even if she becomes a complete abstainer such as yourself, she will still need another 5-10 transplants over the course of her life.

And of course - even if her drug use is affecting her liver adversely - really how very human of her. We all do things that are less than ideal for our health. It's very easy to say how we would do things differently if we were in someone else's shoes - but really that's bollocks.

Finally - be very careful entering into calculations of "worthiness" to receive health care. That is a very slippery slope my friends!!!

It's reasonable to assume that drug use contributed to the failure, if that wasn't the case, well, there'd be nothing to debate about would there? But if the drug use was a significant factor in her first transplant, then it's quite likely to be a factor in her need for a second.

As for calculations of 'worthiness,' obviously one has to be careful, but here, I think , the answer is obvious. If you have two potential recipients, one of whom takes every care of their body in an attempt to gain the most benefit of the liver, and one of whom doesn't, then why on earth would you give the liver to the second? You're wasting it. This isn't about moralizing, or about refusing her treatment because 'she's a druggie,' it's about giving the liver to the person who stands to gain the most benefit from it by a significant margin.

I understand this issue is a little close to home, since we're all drug users here ourselves, but the reality is that when you have a resource as limitted as donor organs, then they have to be used where they'll make the most difference. Giving the addict this liver isn't doing that.

 

[Akhenaten]

Finally - be very careful entering into calculations of "worthiness" to receive health care. That is a very slippery slope my friends!!!

Once you have learned to de-value one form of life then it becomes a case of haggling over price for all others.

 

[chemi]

If I had the time to write long responses I'd be writing pretty much exactly what Crankit has been writing.

PD, I was upset by your response as I highly value your posts and respect your opinion. I don't like to think we were "judging" the girl, rather agreeing with the decision made by the hospital, for the same reason. As Crankit said, when you have 2 patients, 1 who has throughout their life chosen not to use/abuse drugs, and 1 who has, at some point, made the decision to cause harm to their bodies, it does become fairly obvious who should receive the organ. PARTICULARLY after they've already had one. I've heard of people being refused transplants before they've had one - because they were former drug abusers, not even current abusers.

 

[Crankinit]

Step back and look at it objectively for a second. Lets pretend that instead of drug use, she has a chronic disease that will cause damage to her liver at roughly the same rate as her drug abuse would were it continued. Would you give her the liver, knowing it will last her a fraction of the amount of time it could someone else? Of course not. It's not being judgemental, it's not moralizing, it's making the most of a very limited resource.

 

[hyroller]

Yes, I get the point of the argument but you seem to miss the mark on her being a parent... for fucks sake... it isn't nice to will these two children to grow up mother-less... have a think about that, and how devastating it would have been for YOU to grow up without YOUR mum to teach you right, from wrong...hmmmmm...

 

[perthboy]

Yes, I get the point of the argument but you seem to miss the mark on her being a parent... for fucks sake... it isn't nice to will these two children to grow up mother-less... have a think about that, and how devastating it would have been for YOU to grow up without YOUR mum to teach you right, from wrong...hmmmmm...

Who is to say there aren't mothers that haven't dabbled in drugs that need a liver?
Bringing up the children is a slack argument because almost every other person on that waiting list will have loving parents, brothers, sisters and maybe even children...

 

[Jakeperson]

If I ever needed a transplant I think I'd probably refuse.


Really hard to make a judgment on her without knowing all the facts. Just because she has used and abused drugs doesn't make her any less of a person.

 

[phase_dancer]

Again, if I had more time atm, I'd present a few hypothetical scenarios, and see how those condemning might then judge this girl. In the meantime, have a think about this, perhaps considering what the major causes of liver failure are, and how you'd place priority in such cases. As ayjay said

Finally - be very careful entering into calculations of "worthiness" to receive health care. That is a very slippery slope my friends!!!

Chemi, sorry that my criticisms upset you, but I guess this is another sensitive issue. If you look deeper hopefully you might see why I find this sort of judgment so unpalatable.

 

[rosee]

Yes, I get the point of the argument but you seem to miss the mark on her being a parent... for fucks sake... it isn't nice to will these two children to grow up mother-less... have a think about that, and how devastating it would have been for YOU to grow up without YOUR mum to teach you right, from wrong...hmmmmm...

It's an interesting debate but she has not proved herself to show right from wrong as yet.

Also I would be embarrassed to put myself out there like that.

 

[NCUK]

this is a shitty situation that i know all too well. i just lost my father to hep-c and liver failure in april. i was the worst experience of my life. he needed a new liver to survive but he never got one. the worst part is these doctors get your hopes up by putting him on the list, then taking him off. this happened soo many times. i feel for the family and their grief to come

 

[perthboy]

Ok I heard on the radio that apparently the Government is going to fly her to NZ with her father so they can perform the transplant over there.
At least that's the gist of what I heard

 

[8L4YN3]

It's easy to sit here and say she should have stopped using drugs after her first transplant. But a wake up call is not a cure. She'd still face all the same struggles anyone else battling with addiction does. Relapse is part of addiction and recovery.

That being said, I don't think she is the most worthy of the too few donor livers available.

This is basically exactly what i was going to say, 100% agree.

 

[Oldrolla]

To be honest i cant really see how either sides of this argument can form any opinion from the crap article that was originally posted by kingpin (no offence to you kingpin just a shit piece of journalism). Just lots of speculation without any substance.....but some healthy debating none the less

 

[Tripman]

Does anyone in this forum actually read or pay attention to what the others say?

Did anyone read what PD said about living donors... The fact is that she could have a willing donor among her friends. If that was the case then the liver transplant on offer would never have been considered for anyone else so it isn't a case of giving it to a "more worthy" patient. I think some of the people on this board need to take a long hard look at themselves before they begin to judge others.

 

[Crankinit]

But she's not asking for a friend to donate it, she wants to go on the transplant list, in which case yes she's taking it from someone else.

 

[chemi]

Does anyone in this forum actually read or pay attention to what the others say?

Did anyone read what PD said about living donors... The fact is that she could have a willing donor among her friends. If that was the case then the liver transplant on offer would never have been considered for anyone else so it isn't a case of giving it to a "more worthy" patient. I think some of the people on this board need to take a long hard look at themselves before they begin to judge others.

I don't understand why people keep yelling "JUDGER!" at Crankit and myself, this isn't a matter of judgement. It's a matter of what is the best decision in the circumstances. Like someone has said previously, pretend she had no addiction and she had some other disease that was not avoidable, not her fault and couldn't be dealt with. If that disease meant she had a much much lower chance of accepting the liver, adding the fact that she has already rejected one donated liver, I can totally understand why they have had to deny her a second transplant. Like the original article said, 3 people a year die on the waiting list.

I really hope she goes ahead with the live transplant from a relative, it would be great to hear a happy ending to this story.

http://www.news.com.au/national/add...liver-transplant/story-e6frfkvr-1225834549165

Addict Claire Murray offered second chance for liver transplant

TAXPAYERS may have to foot the bill for a dying drug user's flight to New Zealand for life-saving surgery.

Claire Murray, a 24-year-old mother-of-two, has been told by doctors that she only has months to live if she does not receive a liver transplant.

It would be her second transplant after years of drug abuse, including heroin and amphetamines, PerthNow reports.

She has admitted to taking drugs after her first liver transplant last year - but has pledged to make the most of her second chance at life after being told she could not be considered for a second transplant in WA.

Health Minister Kim Hames said there were seven other people in WA who were waiting for their first liver transplant.

He said it would be "patently unfair" for Ms Murray to jump the queue for a second liver.

But Dr Hames said the State Government was prepared to pay for her and her father to travel to New Zealand so she could be considered for a "live" liver transplant.

The procedure would use a piece of a liver from a living family member.

Ms Murray's father Michael today told ABC radio that his daughter would die within months without a second chance liver transplant.

"This is a complex and emotional case and the decision not to put Ms Murray back on the waiting list for a liver transplant was made by a team of experts in the field,'' Dr Hames said.

"It's important to remember we do not have enough donor organs in Western Australia, and someone has to die to provide a sick person with an organ. Last year, three people died while waiting for a liver transplant.

"We have offered to fly Ms Murray to New Zealand where she can be reviewed for a live person-to-person liver transplant.

"That procedure is not done anywhere in Australia, but it involves taking about a third of the liver from a willing donor, and transplanting it into the patient.

"There are risks associated in that procedure both for the donor and the patient and there is no guarantee that Ms Murray would be suitable.

"I have a great deal of sympathy for the Murray family.”

 

[phase_dancer]

"That procedure is not done anywhere in Australia, but it involves taking about a third of the liver from a willing donor, and transplanting it into the patient.

It has actually been performed once in Aus, and in WA at that.

from Medical Journal Australia

Postoperative details


The donor was extubated several hours after leaving the operating theatre and, after 24 hours in the intensive care unit, was transferred to the general ward. Recovery was complicated by right basal atelectasis, which was treated by intensive chest physiotherapy. All liver function tests were normal at discharge on Day 6. A staphylococcal infection in the drain wound required a two-day readmission, but responded to flucloxacillin treatment. The donor returned to normal full activities four weeks later.

The recipient made a slower postoperative recovery. There was an immediate improvement, and extubation occurred on the fifth day after surgery, with transfer to the general ward on Day 7. At this time her serum bilirubin level was 242 µmol/L, serum ALT level was 262 U/L, and INR was 1.2, improved from the pre-surgery values of 670 µmol/L, 1060 U/L and 5.1, respectively. Her serum lactate level was 8.1 mmol/L (normal, < 1.3 mmol/L). Complications included Staphylococcus aureus septicaemia, right middle and lower lobe consolidation, and an episode of severe acute graft rejection. On the 33rd day after surgery, the recipient was discharged. Two months after transplantation, her serum bilirubin level was 341 µmol/L, serum alkaline phosphatase level was 374 U/L (normal, 35-135 U/L), and serum ALT level was 80 U/L. A stricture of the biliary anastomosis was stented at this time.

Three months after transplantation, there was still no filling of the right posterior bile duct, necessitating laparotomy and reanastomosis of the duct. The patient made an uncomplicated recovery and was discharged on Day 7.

Persisting abnormal liver function tests at five and a half months led to a liver biopsy. Moderately severe chronic rejection was diagnosed, and the immunosuppressive medication was changed from cyclosporin to tacrolimus. At 12 months, results of liver function tests were normal and the recipient had returned to normal activities.

 

[thestudent14]

Ure a wise man phase dancer.

 

[eon_blue]

The real tragedy here is that there are actually people in this world selfish enough to keep their organs to their useless selves after death, thereby denying another the chance to continue living. If everyone was a donor there wouldn't be such a long waiting list with so many restrictions on who is and who isn't eligible. Maybe there wouldn't even be one at all.

It's the very epitome of selfishness, to such a degree that I think the very word itself hardly does the concept any justice.

 

[NCUK]

Does anyone in this forum actually read or pay attention to what the others say?

Did anyone read what PD said about living donors... The fact is that she could have a willing donor among her friends. If that was the case then the liver transplant on offer would never have been considered for anyone else so it isn't a case of giving it to a "more worthy" patient. I think some of the people on this board need to take a long hard look at themselves before they begin to judge others.

it is really hard to get a living doner as well... first of all it has to be someone with the same genetics as you... "pref. a sibling bt in rare cases a child" even if you find a sibling willing to donate a third of their liver the tests for combatibility are rigorous. they have to be 100% sure the donor wont die. most of the time it doesnt work out. it sucks as in my case