Liver Transplant Scam Exposed March 26, 2009
Posted by Bob Aronson in SCAMS.add a comment
It is unfortunate but there are some people who seek to take advantage of the misfortune of others. While I find it hard to believe that anyone would take advantage of people seeking organ transplants, it happens and via this blog I will endeavor to expose as many of these people as I can.
Remember, if it seems too good to be true, it probably is. Before you make any decisions about potential transplant possibilities in other countries check with your local Organ Procurement Organization (OPO), The United Network for Organ Sharing (UNOS) www.unos.org, or your state’s Attorney General’s office.
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On March 19, 2009 Sue Weibezahl Porter of the Syracuse NY Post-standard wrote the following story under the headline: (http://blog.syracuse.com/healthfitness/2009/03/international_organ_transplant.html)
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Organ transplant scam preyed on dying people, ends with capture of Syracuse man
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Federal prosecutors announced this afternoon that Jerome Feldman, 67, was captured in the Philippines and will be extradited to Syracuse on charges he scammed dying people by setting up phony organ transplant surgeries. Feldman had them wire money — more than $400,000 — to the Chase Bank in DeWitt and also had postal boxes in Fayetteville and DeWitt for more checks, authorities said.
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It’s not the first time he’d been in trouble. His New York State medical license was revoked. Feldman, who has family ties in Central New York, allegedly trolled Web sites looking for people who needed transplants. Using phony names, he would promise to set up the surgeries if the people would wire money in advance. FBI investigators have identified at least five victims, most of whom died after arriving in the Philippines and discovering the doctor who was supposed to perform the life-saving surgery did not exist. Feldman faces up to 20 years in federal prison and fines totaling more than $250,000.
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Authorities are also trying to freeze, then seize, his assets.
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If and as we find more of these frauds who prey on people’s worst fears and infirmities we will expose them. In the meantime if you are aware of a person or organization that appears to be a scam let us know and we’ll do what we can to get to the truth.
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Please comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be a donor you may have saved or affected over 50 lives.
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Also, please read and comment on my World Wide Issues blogs on http://blogsbybob.wordpress.com. I ask, too, that you visit and join my Facebook site, Organ Transplant Patients, Families and Friends at http://tinyurl.com/225cfh OR — my Facebook home page http://www.facebook.com/home.php
“First Person Consent” Can Increase Organ Donation March 22, 2009
Posted by Bob Aronson in Organ Donation.7 comments
In the March 2009 edition of the Virtual Mentor The American Medical Association Journal of Ethics has published a paper in support of “First Person Consent,” a concept that could increase the number of organs available for transplantation. Now effective in 42 states, “First Person Consent” laws dictate that a documented donation decision like a donor card, drivers license etc, is legally binding and does not require the consent of any other person upon the death of the donor. That means if a person has documented their decision to be a donor, families have no legal right to overrule it. You can read the report in its entirety at http://virtualmentor.ama-assn.org/
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I’ll explain the rationale in a moment but in order to make the concept effective two things must be done, 1) more people need to document their wishes. That means that we should consider enacting laws in every state that require people to make a decision on donation when they renew their drivers license. 2) Medical personnel need to defer to the expertise of Organ Procurement Organizations (OPOs).
To further quote from the AMA report,”The death of most people who become deceased organ donors is sudden, unexpected, and frequently tragic. The families of these donors are almost never prepared for this unfortunate situation. “The refusal of families to grant permission is a major impediment to organ donation. If, despite the law, we must get family consent, several factors have been shown to improve family consent rates:
First, the request for organ donation should be separate—or “decoupled”—from the declaration of brain death. This allows the family time to understand and accept the concept of brain death.
Second, the request for organs should be made by a trained OPO representative along with the hospital staff as a team. It is best that the physician or nurse caring for the patient not discuss organ donation with the family prior to OPO involvement. The hospital staff and OPO donation coordinator can work together to determine the best time to talk to the family.
Third, the request should be made in a private and quiet setting. Higher consent rates have been shown to occur when these 3 procedures are followed [1].(clicking on the number will provide further information).”
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The AMA report continues, “First-person consent removes a burden from family members because they do not have to come to a decision while attempting to cope with the very stressful situation of the death of a relative. First-person consent also avoids the problem of family members’ disagreement, and it may benefit families later on: more than one-third of families who made a decision themselves and declined to donate the organs subsequently regretted their decision [2].”
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The Virtual Mentor also says, “The medical care team must, to the greatest extent possible, remove itself from this conflict resolution process and rely upon the expertise of the organ procurement professionals. It is likely that the procurement coordinator has been in similar situations, has been trained to deal with them, and will be able to adequately resolve most of the issues to the satisfaction of all.
The AMA report is very emphatic, though, on the need for OPOs to develop and maintain a close working relationship with donor families. “Although the law is on the side of the designated donor, it is critical to procurement organizations, transplant centers, and recipients that the OPO make a concerted effort to establish a cooperative relationship with the family. Legal and public conflicts that could result in fewer donors must be avoided. Willing participation from the family will also enable the procurement coordinator to obtain a thorough medical and social history, and will allow him or her to explain the procedure fully, confirm that donation will not interfere with the funeral, clarify that the OPO will assume hospital costs related to the donation, and convey much other information.
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Perhaps the most compelling reason to establish a positive relationship with the family of a potential donor is the benefit it offers to the future of organ donation. Working cooperatively with the donor family will result in a positive continued relationship. The surviving family members of a donor are known as donor families and, in our mission to increase awareness of the need for more organ donors, donor families remain an unparalleled resource for promoting the message.”
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I am a believer in adopting a system of presumed consent. One in which people could opt out rather than opt in. In countries where this has been tried donation rates have increased substantially. But presumed consent requires a change in the law. First Person Consent is already the law in all but 8 states. What needs to be done is to fine-tune the system so we can eliminate the obligation OPOs and hospital officials feel to get donation permission from families. Under First Person Consent laws no permission is necessary and that could mean a significant increase in available organs. Perhaps if the AMA suggestions were adopted we might be a step closer to closing the organ donation/transplantation gap.
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Please comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be a donor you may have saved or affected over 50 lives.
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Please read and comment on my World Wide Issues blogs on http://blogsbybob.wordpress.com. Also…visit and join my Facebook site, Organ Transplant Patients, Families and Friends at http://tinyurl.com/225cfh OR — my Facebook home page http://www.facebook.com/home.php
Kidney For Sale; The Case for Compensating Donors March 17, 2009
Posted by Bob Aronson in Donor Compensation.13 comments
THIS IS NOT AN OFFER TO BUY ORGANS. ATTEMPTS TO SELL ORGANS HERE WILL NOT BE PUBLISHED.
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Let me begin by quoting Sally Satel M.D., Kidney transplant recipient and Resident Scholar American Enterprise Institute: (Kidney for Sale, Lets Legally Reward the Donor http://www.aei.org/publications/filter.all,pubID.29515/pub_detail.asp)
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“America faces a desperate organ shortage. Today, more than 78,000 people are waiting for a kidney transplant; only one in four will receive one this year, while twelve die each day waiting for help. Not surprisingly, many patients are driven to desperate measures to circumvent the eight-year waiting list—renting billboards, advertising in newsletters, or even purchasing organs on the global black market. Altruism (the current system where one donates an organ through the goodness of their heart) is an admirable but clearly insufficient motivation for would-be donors.
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According to the International Society of Nephrology, kidney disease affects more than 500 million people worldwide, or 10 per cent of the adult population. With more people developing high blood pressure and diabetes (key risks for kidney disease), the picture will only worsen.
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There are nearly two million new cases of the most serious form of kidney disease–renal failure–each year. Unless patients with renal failure receive a kidney transplant or undergo dialysis–an expensive, lifelong procedure that cleanses the blood of toxins–death is guaranteed within a few weeks”
The argument against paying people for their organs (living donors of kidneys and livers) is that the practice would prey on the poor. Supposedly only people who are in desperate need of money would sell their organs. “The rich or reasonably well off,” the argument goes, “Don’t need the money so few of them would become donors under such a system.” Additionally, wealthy people could buy organs from the poor but the poor could not afford to buy organs if they needed them. So the question; “Is it ethical to compensate people for their organs?” My answer is, probably not – if the exchange is simply cash from the recipient to the donor for a kidney. But what if there are other considerations? Dr. Satel offers some interesting options:
“My colleagues and I suggest a system in which compensation is provided by a third party (government, a charity or insurance) with public oversight. Because bidding and private buying would not be permitted, available organs would be distributed to the next in line–not just to the wealthy. Donors would be carefully screened for physical and psychological problems, as is currently done for all volunteer living kidney donors. Moreover, they would be guaranteed follow-up care for any complications.
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Many people are uneasy about offering lump-sum cash payments. A solution is to provide in-kind rewards–such as a down payment on a house, a contribution to a retirement fund, or lifetime health insurance–so the program would not be attractive to people who might otherwise rush to donate on the promise of a large sum of instant cash. The only way to stop illicit markets is to create legal ones. Indeed, there is no better justification for testing legal modes of exchange than the very depredations of the underground market.”
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Dr. Satel goes on to say that, “Momentum is growing. In the British Medical Journal, a leading British transplant surgeon called for a controlled donor compensation program for unrelated live donors. Within the past year, the Israeli, Saudi and Indian governments have decided to offer incentives ranging from lifelong health insurance for the donor to a cash benefit. In the United States, the American Medical Association has endorsed a draft bill that would make it easier for states to offer non-cash incentives for donation.”
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Dr. Satel and her colleagues call on Congress to reform the 1984 National Organ Transplant Act (NOTA), which makes it a felony to provide material reward for an organ. The authors suggest that:
• Congress should amend NOTA so that existing criminal penalties for selling and brokering organ sales between individuals do not apply to any economic incentives offered by federal, state, or local governments. Such a revision would not require any such incentives; it would simply allow states and federal agencies to undertake experimental incentive programs.
• Compensation to prospective donors could take the form of health insurance, tax credits,
tuition vouchers, or contributions to tax-free retirement accounts.
• Rigorous protections for the safety of donors would be created.
• Because the compensation would be provided by the government, every patient in need
would benefit, regardless of income.”
The issue of paying for human organs is controversial to say the least but that does not mean it can’t or won’t work. Iran, which is usually not a good example for much of anything, allows for such a program and the result reportedly is that their waiting list has sharply declined and in some cases it has diminished entirely.
http://freakonomics.blogs.nytimes.com/2008/04/29/human-organs-for-sale-legally-in-which-country/
What we need in the United States is an open dialogue free of emotional outbursts that would allow for a small pilot program to test the concept. We need universal agreement on the need to elminate organ transplant waiting lists, much like the commitment the National Kidney Foundation made to eliminating the kidney waiting list within ten years. We must also agree, though, that the altruistic approach that we’ve tried for the last quarter of a century does not work. Every year the number of people who die while waiting for a transplant grows, yet we continue to cling to the notion that if we work a little harder more people will become donors. Well, everyone has worked very hard and we are still losing the battle. As I have written before about the United Network for Organ Sharing (UNOS) which regulates the entire process, “It’s not working and it is time we tried something that will work, we must stop the dying.” We’ve got to do something new and a pilot program somewhere in the United States would be a great way to start. What have we got to lose?
Please comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be a donor you may have saved or affected 50 or more lives.
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Please read and comment on my World Wide Issues blogs on http://blogsbybob.wordpress.com. Also…visit and join my Facebook site, Organ Transplant Patients, Friends and You at http://tinyurl.com/225cfh OR — my Facebook home page http://www.facebook.com/home.php
Myths Inhibit Organ Donors, Kill People March 13, 2009
Posted by Bob Aronson in Organ Donation.2 comments
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Sometimes on WordPress, the formatting goes berserk. It did in this post and I apologize for the variances in print style but it was beyond my control.
Some of the greatest barriers to organ donation are urban myths and there are hundreds of them. Primary among them, though, is the tale that doctors will let you die so they can recover your organs. This lie seems to have risen from a single unresolved case in a California hospital in 2006. Before we get to that, though, here are two examples of how this myth manifests itself into supposedly true stories thereby preventing people from becoming organ donors.
- “My wife does not want me to be an organ donor because a few of her friends (who “just so happen to be ER nurses”) claim that when an organ donor is in a life & death situation on the table, doctors will not try and save them so that their organs may be used. This sounds like it defeats the purpose; letting one die so another can live. But, she swears that it’s true.”
- “I heard that having the pink organ donor ticket on your driver license will cause the Paramedics to allow you to die in order to harvest your organs. The rumor claims that due to the long list of people on the organ waiting list, the Paramedics are instructed to allow organ donors to die.”
First and foremost it is important to note that the medical team treating you in a hospital or ER is completely separate from the transplant team. The organ procurement organization (OPO) is not notified until all lifesaving efforts have failed and brain death has been determined by certified neurologists. The OPO does not even notify the transplant team of organ availability until the donor’s family has consented to donation.
Snopes.com, a wonderful source for dispelling myths, rumors and outright lies offers a concise and accurate explanation (http://www.snopes.com/medical/emergent/donor.asp) I encourage you to click on the link and read the entire entry but here are some of the more salient points.
“While the rumor would appear to confirm the belief that physicians involved in harvesting organs will happily sacrifice one patient in their efforts to secure parts for others, such belief overlooks one particular facet of this conjecture: Doctors who fail to provide their best medical care to their patients can and will be sued. As professional healers, they are held to a higher legal “standard of care” than is the average person and thus aren’t afforded the luxury in life or death situations of not attempting to do all in their power to save those whose lives hang in the balance. Additionally, in those instances where patients died, doctors who did decide to scale back care could well be charged with homicide.”
So you might ask, “How did this rumor get started?” Again, according to Snopes:
“The rumor about organ-hungry doctors prematurely offing potential donors gained an unfortunate shot in the arm from a 2006 case in San Luis Obispo, California. Ruben Navarro, a 25-year-old man who suffered from the neurological disorder adrenoleukodystrophy as a child (by his early 20s his mental and physical condition had deteriorated to a point where he was placed in an assisted-care facility), was admitted lifeless and unresponsive to the Sierra Vista Regional Medical Center on 29 January 2006. His organs were subsequently retrieved for transplant five days later. (Those transplants, by the way, never took place because Navarro survived for more than seven hours after he was removed from life support and was given certain drugs, so his organs had deteriorated too much to be usable.)
Prosecutors have charged Dr. Hootan C. Roozrokh, the surgeon who removed Navarro’s organs, with felony counts of dependent adult abuse, mingling a harmful substance (Betadine) and prescribing a controlled substance (morphine and Ativan) without medical purpose. It is their assertion that rather than allow Navarro to die naturally, the doctor knowingly hastened the process by introducing into him excessive amounts of narcotic painkillers and sedatives for the express purpose of killing him. The doctor is also said to have administered the antiseptic Betadine through a feeding tube into Navarro’s stomach while Navarro was still viable, a sterilization procedure typically done after a donor is dead (since it’s likely to kill the living).
Roozrokh’s attorney says Navarro “was going to die shortly, whether in minutes or in hours” and said of the excessive painkillers used that “In that situation, you err on the side of ensuring that he’s pain-free.” Over-medicating the dying with morphine is not at all a new practice; terminal patients are sometimes given unusually high or overly-frequent doses of the drug in an effort (generally unstated but also generally understood by both medical staff and family members in attendance) to help the dying slip through death’s door a bit more quickly and thus terminate sufferers’ torments sooner. Such practice is generally roundly denied when spoken of openly, however.
Dr. Roozrokh continues to practice, pending the verdict in his case.”
If you would like comprehensive information on other organ donation/transplantation myths please visit http://www.iaod.org/myths-organ-donation.htm
Please comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be a donor you may have saved or affected over 50 lives.
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Please read and comment on my World Wide Issues blogs on http://blogsbybob.wordpress.com. Also…visit and join my Facebook site, Organ Transplant Patients, Friends and You at http://tinyurl.com/225cfh OR — my Facebook home page http://www.facebook.com/home.php
National Kidney Foundation — “End Kidney Shortage By 2019″ March 10, 2009
Posted by Bob Aronson in New Ideas.4 comments
The month of March is National Kidney Month and March 12, 2009 is World Kidney Day. These dates are significant because they mark the beginning of a commitment by the National Kidney Foundation (NKF) to “End the Wait” for a kidney transplant in the United States in the next decade. This effort needs and deserves your support. Thousands of lives depend on it. At this very moment nearly 80,000 of the 101,000 people on the national transplant list are waiting for kidneys, many of them will die waiting.
There are two sources for kidneys, 1) living donors and 2) deceased donors. While only about half of all donated kidneys come from living donors medical evidence indicates better outcomes for recipients of these life saving gifts. It is also noted that if a living donor lives a healthy lifestyle he/she can have a normal lifespan with just one kidney.
I’m going to let the NKF speak for itself in this blog. I will offer little comment other than to say the organization has committed itself to developing almost every avenue to increase the number of kidneys available for transplant. They have wisely avoided addressing the issue of paying donors for their organs. I will do that in a future blog.
In essence, NKF is advocating a multi-faceted collaborative initiative. What follows are excerpts from that initiative. http://www.kidney.org/news/end_the_wait/index.cfm
“Rather than focusing on single issue tactics, these broad based actions will achieve the common goal that everyone agrees on – ending the wait for a transplant. It uses proven and tested strategies, each of which is already successful in some areas and which should now be implemented everywhere. (The full list of NKF’s Recommendations is attached and is available on the NKF website www.kidney.org)
- We can improve the outcome of first transplants, reducing the need for a return to the waiting list.
- We should pay for immunosuppressive drugs for the life of the recipient.
- The loss of a transplant is one of the leading reasons for starting dialysis. Reducing that problem will make more kidneys available.
- We can improve the health of recipients, transplant them earlier when their condition is better, educate them about their options and ask them sooner, “Do you have a donor?”
- We can also increase the number of organs available from deceased donors.
- We can improve the care of donor families in hospitals and support them while they are with their loved one.
- We can increase the use of proven techniques such as extended criteria donors and donation after cardiac death throughout the country.
- And, we can make sure that donor families don’t incur any additional costs because of the donation, including extra funeral costs.
Increasing the number of living donors is vital to meeting our goal.
- Living donors and potential donors should receive state-of-the-art care and never suffer financially because of their donation.
- We can cover all the costs of donation, including lost wages.
- We can track donor outcomes and make sure they have health care coverage and life insurance for anything that happens related to the donation.
- And, a program of matched donation should be available throughout the United States.
Living donors and potential donors are our constituents, too. NKF will establish a Living Donor Council to support their needs. They should always have the best information about the donation process to help them make decisions that are right for them.
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We also can improve the American system of organ donation and transplantation. Many challenges are resource-based. We can increase the number and skills of people working in transplant programs nationwide to reduce the time it takes to complete the living donation process. All potential living donors should have access to laparoscopic nephrectomy.
Summary
This can be done. It won’t be easy but the goal is worth the effort. We can End The Wait! We can leave existing laws as they are and write new ones that address the whole problem. We can have a dramatic impact on the health of all our patients and our country.
The National Kidney Foundation will commit itself to leading the effort. If the community responds and reaches above individual priorities and single issues, the goal can be met. The challenges are many and the work will be hard. But, it’s the only way to do what our patients need us to do: END THE WAIT!”
Please read and comment on my World Wide Issues blogs on http://blogsbybob.wordpress.com. Also…visit and join my Facebook site, Organ Transplant Patients, Friends and You at http://tinyurl.com/225cfh OR — my Facebook home page http://www.facebook.com/home.php
Eating Disorders Destroy Multiple Organs March 8, 2009
Posted by Bob Aronson in Transplant prevention.2 comments
The best way to increase the number of transplantable organs is two-fold; 1) increase the number of organ donors and 2) diminish the need for organs. Only by combining the two will we be able to end the disgraceful upward spiral of people who die while waiting for transplants.
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Eating disorders number among the top organ destroyers of all diseases because Anorexia and Bulimia can destroy virtually all of the organs – making transplants next to impossible. Which organ do you transplant and does it make sense to do so if the patient still suffers from the disease?
Too many people fail to recognize just how dangerous eating disorders can be, and if we are to diminish the need for organs we must address these terrible diseases as early in the process as possible. They are treatable but become less so as the disorders age.
The question is often asked, “Which organs do anorexia and bulimia destroy?” The answer according to wiki answers.com (http://wiki.answers.com/Q/What_organs_does_anorexia_destroy_in_your_body_and_what_are_the_long_term_affects_of_anorexia) is, “Nearly all of them, because of the lack of nourishment.” Wiki adds that the damage goes well beyond what one might expect, “The effects of anorexia and bulimia that can persist throughout the victim’s lifetime are a higher risk of developing osteoporosis later due to the deprivation of calcium, infertility or difficulty conceiving, anemia, stunted growth (in adolescent victims), psycho-neurological problems, ex. depression and anxiety, and neurological problems, ex. seizures, peripheral neuropathy which is a tingling and numbness in the limbs. Diabetics who had anorexia risk a likely chance of developing retinopathy, an eye condition that often causes blindness. Some such as infertility and neurological complications are often permanent.”
Still another source (http://ezinearticles.com/?Long-Term-Effects-of-Bulimia-Nervosa&id=1014462) says, “The heart gets damaged from the constant electrolyte imbalances caused by continuous purging and becomes weaker the longer the disorder continues. Some people even can die from this complication when a weak heart goes into a “heart block”. This is when the heart suddenly stops beating due to extremely low potassium or other mineral deficiency induced by vomiting and laxatives abuse.
Kidney damage is very common. The kidneys are organs that normally correct mineral abnormalities in the body. But when a person’s mineral balance is constantly disturbed, they get damaged.
The brain suffers also from the moment bulimia starts.
The digestive system also gets affected badly. The stomach experience delays in empting its food content and people suffer from pains in the abdominal area, bloating, acid reflux, stomach ulcers and esophageal problems.
The bones become weak due to the development of low bones density and the bones can break from even minimal strain or pressure.
Skin looses its youthful look even at a relatively young age. Hair loss due to mineral and protein depletion is inevitable in the long term.
The endocrine glands eventually stop working properly and produce fewer hormones than the body needs: this makes a person age quickly and loose muscle tone.”
The list of problems caused by eating disorders is endless but the solutions are not simple. Eating disorders like chemical dependency and depression are not easy to treat and some people don’t respond at all. If we are to address diminishing the demand for organ transplants, though, we must take these diseases much more seriously. For more information on eating disorders click on the above links or the National Eating Disorders Association (NEDA) http://www.nationaleatingdisorders.org/
Please comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be a donor you may have saved or affected 50 lives.
Please read and comment on my World Wide Issues blogs on http://blogsbybob.wordpress.com. Also…visit and join my Facebook site, Organ Transplant Patients, Friends and You at http://tinyurl.com/225cfh OR — my Facebook home page http://www.facebook.com/home.php
How Alcohol Can Kill Your Liver — And You March 4, 2009
Posted by Bob Aronson in Uncategorized.4 comments
The response to my blog; Should Alcoholics Get Liver Transplants, was overwhelming. I’ve been posting for a little over a year and no other blog has generated a response as heavy as this one. Because so many people were interested in the effect of alcohol on the liver, I decided to offer a brief expansion of the topic.
I think it is important to point out here that while I am a recovering alcoholic I am not anti-alcohol. There are, though, some instances where abstinence is absolutely necessary. Such is the case with liver disease.
According to the American Liver Foundation (ALF), (http://www.liverfoundation.org/education/info/alcohol/)
the liver breaks down alcohol so it can be eliminated from your body. If you consume more alcohol than the liver can process, the resulting imbalance can injure the liver by interfering with its normal breakdown of protein, fats, and carbohydrates.
The ALF says there are three kinds of liver disease related to alcohol consumption:
Fatty liver is marked by a build-up of fat cells in the liver. Usually there are no symptoms, although the liver may be enlarged and you may experience discomfort in your upper abdomen. Fatty liver occurs in almost all people who drink heavily. The condition will improve after you stop drinking.
Alcoholic hepatitis is an inflammation of the liver. Up to 35 percent of heavy drinkers develop alcoholic hepatitis. Symptoms may include loss of appetite, nausea, vomiting, abdominal pain and tenderness, fever and jaundice. In its mild form, alcoholic hepatitis can last for years and will cause progressive liver damage. The damage may be reversible if you stop drinking. In its severe form, the disease may occur suddenly, after binge drinking, and it can quickly lead to life-threatening complications.
Alcoholic cirrhosis is the most serious type of alcohol-induced liver disease. Cirrhosis refers to the replacement of normal liver tissue with scar tissue. Between 10 and 20 percent of heavy drinkers develop cirrhosis, usually after 10 or more years of drinking. Symptoms of cirrhosis are similar to those of alcoholic hepatitis. The damage from cirrhosis is not reversible, and it is a life-threatening disease. Your condition may stabilize if you stop drinking.
Many heavy drinkers will progress from fatty liver to alcoholic hepatitis and finally to alcoholic cirrhosis, though the progression may vary from patient to patient. The risk of developing cirrhosis is particularly high for people who drink heavily and have another chronic liver disease such as viral hepatitis C.
The ALF makes it very clear that if you have any liver disease you must stop drinking, period! “Your doctor may suggest changes in your diet and certain vitamin supplements to help your liver recover from the alcohol-related damage. Medications may be needed to manage the complications caused by your liver damage. In advanced cases of alcoholic cirrhosis, the only treatment option may be a liver transplant. However, active alcoholics will usually not qualify as suitable organ recipients.”
Once people become aware of the dangers alcohol poses to the liver, the first question they ask is, “Can I drink at all? Is there a safe level of drinking?” Here’s ALF’s response:
“For most people, moderate drinking will not lead to alcohol-induced liver disease. Moderate drinking means no more than one drink a day for women and two drinks a day for men. (A standard drink is one 12-ounce beer, one 5-ounce glass of wine or one 1.5-ounce shot of distilled spirits.) However, for people with chronic liver disease, especially alcohol-induced liver disease, even small amounts of alcohol can make the liver disease worse. Patients with alcohol-induced liver disease and those with cirrhosis from any cause should stop using alcohol completely.
Women are more likely to be affected by alcohol-induced liver disease because women can be affected by smaller amounts of alcohol than men.”
Finally The American Liver Foundation says: “Serious complications from alcohol-induced liver disease typically occur after many years of heavy drinking. Once they do occur, the complications can be serious and life-threatening. They may include:
· Accumulation of fluid in the abdomen
· Bleeding from veins in the esophagus
· Enlarged spleen
· High blood pressure in the liver
· Changes in mental function, and coma
· Kidney failure
· Liver cancer”
The basic philosophy behind this blog is to advance organ donation but because there is such an organ shortage it is important, too, to protect our organs. Steps can be taken to avoid needing an organ transplant. Moderation of alcohol consumption is one of them.
Please comment here or email your comments to me at bob@baronson.org.
Please read and comment on my World Wide Issues blogs on http://blogsbybob.wordpress.com. Also…visit and join my Facebook site, Organ Transplant Patients, Friends and You at http://tinyurl.com/225cfh OR — my Facebook home page http://www.facebook.com/home.php
Should Alcoholics Get Liver Transplants? March 1, 2009
Posted by Bob Aronson in Alcohol.17 comments
This is a “think piece.” I’m hoping this blog will challenge your thinking and cause you to comment. I am taking no position on this issue, I am simply asking some very important questions.
Heavy drinking or alcoholism can severely damage our organs and the liver seems to be the most susceptible to such damage. So – if you were to ask the average person if alcoholics should be eligible for liver transplants the answer would likely be a resounding, “NO!”
As with most things in life, though, nothing is that simple. If transplant eligibility depended on us living healthy lifestyles then there would be no organ shortage because few people would qualify for the life-saving procedure.
According to a study, published in the April 25th edition of the Archives of Internal Medicine, led by Mathew J. Reeves who is the lead researcher and epidemiologist at Michigan State University, only 3% of Americans lead a healthy lifestyle. Reeves says a healthy lifestyle that includes not smoking, maintaining a healthy weight, regular exercise and a diet containing lots of fruits and vegetables lessens the risk of developing diabetes, cardiovascular disease and cancer. http://www.qualityeldercare.com/healthy.html
Back to the question on heavy drinking and liver transplants. Just what is heavy drinking? You may be surprised to learn that population-based surveys indicate that 68 percent of adult Americans drink at least one alcoholic beverage per month. About 10 percent consume more than two drinks per day, which is a commonly used definition of “heavy drinking”. Two drinks a day! http://www.enotalone.com/article/11240.html
Let’s ask the question again, “Should alcoholics or heavy drinkers be eligible for liver transplants?” Well, I am an alcoholic and had a heart transplant eighteen months ago. It Is likely that my alcoholism contributed to the disease that destroyed my original heart. I quit drinking in 1982 and have had no relapses but I am an alcoholic and always will be. Should I have been denied a transplant?
Should the obese person suffering from diabetes be denied treatment? Driving too fast is one of the top killers of American men, should the person with a speeding record be denied a transplant because they are likely to kill themselves? What about people who have anorexia, bulimia and other lifestyles that could be considered self destructive? Should prisoners be denied transplants even though they might someday be released? I fear that once we go down this road it is unlikely we would treat or transplant anyone.
I am not trying to justify transplanting livers into practicing alcoholics, but if you accept the American Medical Association (AMA) position that alcoholism is a disease, should the patient be punished because of it? Do we punish cancer patients because they have cancer? There is a school of thought based on limited research that suggests a liver-transplant recipient was statistically more likely to reject a new liver than to destroy it from continued drinking. The fact is that most transplant programs around the world require at least six months of alcohol abstinence before they will consider a transplant. But if two drinks a day is heavy drinking, the average person may be only a few drinks a week away from being a member of that group.
I began by saying that this is a “think piece.” I wrote it because I want to hear from you. Where do we draw the line on who is and who is not eligible for a transplant? The medical community has some solid guidelines, for example cocaine use in most cases will automatically eliminate a person from being considered for a transplant. The public however, as was evidenced in the Mickey Mantle case, may not agree with the medical professionals. What do you think? Being as there is a shortage of organs and thousands die each year because of it, should we more severely limit who is eligible for a transplant?
Please comment here or email your comments to me at bob@baronson.org.
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