Liver transplant policy is arbitrary, inhumane
Liver transplant policy across North America relating to alcoholics often appears based more on politics and public perception than facts, many experts say.
As a result, a widely-used — but essentially arbitary — six-month abstinence rule for potential liver transplant recipients basically equates to a death sentence for those who don’t meet those criteria.
On Friday, that was the situation possibly facing Delilah Saunders, the 26-year-old sister of 2014 murder victim Loretta Saunders being treated at a Toronto hospital Friday for acute liver failure caused by acetaminophen toxicity in conjunction with alcohol abuse. She had checked into an Ottawa hospital a week earlier feeling unwell after taking Tylenol for pain.
The Labrador- born Indigenous activist recently won Amnesty International’s human rights award for her advocacy work.
In October in Membertou, she gave emotionally charged testimony about her sister at the national inquiry into missing and murdered Indigenous women and girls.
Under Ontario’s liver transplant policy, Saunders was ruled not eligible for a liver transplant, even from a family member or friend who’s a match, because she hasn’t been alcohol-free for at least six months.
Ontario is already facing a lawsuit over its policy from the widow of a man who died after similarly being denied a liver. In that suit, Dr. John Fung, chief of transplant surgery at the University of Chicago and a member of the U.S. government’s advisory panel on transplantation, testified that studies show alcoholic liver disease patients do as well as other liver transplant recipients and rarely resume heavy drinking.
Fung also said it’s official policy of both the American Association for the Study of Liver Disease and American College of Gastroenterology that alcoholics be treated the same as other people with liver failure.
Trillium Gift of Life Network, which oversees Ontario’s liver transplant program, has responded by offering to launch a three-year study next August that will waive its six-month policy for up to 100 people with re- cent substance abuse.
But Trillium has also said it’s concerned a permanant change to the policy could increase wait times and undermine public support for the transplant program.
With respect, those aren’t convincing arguments to deny people suffering now, especially given the lack of evidential support for the current policy. And in this case, Trillium has denied Saunders’ family and friends the opportunity to even donate part of their own livers, if a match, to save her life. In such cases, the livers of both donor and recipient normally regrow to normal size in about three months.
Saunders’ family also have a strong argument Trillium’s policy discriminates against Indigenous people, who have a disproportionate rate of substance abuse due to the trauma inflicted by residential schools.
Happily, there was news Friday that Saunders was responding to treatment and improving at an organ transplant centre in Toronto.