10mo ago

Woman who was denied a liver transplant, after review highlighted alcohol use, has died

www.ctvnews.ca Woman who was denied a liver transplant, after review highlighted alcohol use, has died

Questions are being raised about the case of a 36-year-old Ontario woman who died of liver failure after she was rejected for a life-saving liver transplant after a medical review highlighted her prior alcohol use.

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Jesus Christ that’s fucked up. Only 36 too and stopped drinking… and had a willing living donor. What do you do in this situation when they won’t help you? Go down to Mexico?
- Well, stopped drinking when she got the diagnosis, not before, didn't comply with medical advice to stop drinking before hospitalization, and as they said in the article there are a lot of criteria for a living donation, and it's only an option if you otherwise qualify for a donation because of the possibility of rejection requiring an urgent transplant.
  A different article said they were trying to raise funds to get the transplant done at an unspecified European hospital, so "yes". I think it's telling that they didn't go to the US, a north American country, or specify the country.
  It's worth remembering that the only people who can talk freely are the people who were decided against and are talking about suing.
  No one wanted her to die, but with organ transplants it's a case where you're more or less picking who will die. Phrasing it as being punished for bad behavior is unfair to the people who need to decide which people are likely enough to benefit, which isn't easy.
  
  I didn’t catch the part where she relapsed after diagnosis. For fucks sake how much was this lady drinking to get liver failure at 38?
  
  It actually takes surprisingly little if it's done consistently and without giving your body time to rest.
  A standard drink has roughly 14g of ethanol in it. People with notable liver damage tend to have a history of a decade or more drinking 30-50 grams a day, or two to three drinks.
  People who drink more than 80g a day for a decade are almost guaranteed to have liver problems (~5-6 drinks).
  Obviously drinking a half gallon a day is worse, but consistent long term drinking is also not great.
  It is essentially a poison that's only around because it's easy to make and traditional at this point.
  
  heavy drinking – a term defined as five or more drinks for males, or over four for females, on one occasion at least once per month in the past year.
  What the article calls heavy drinking, would have been nothing to me when I was an active alcoholic. Towards the end I'd be drinking anywhere from a pint to a fifth of bourbon a day. I was an active alcoholic for over a decade, running from age 23-33. I'm thankful that I was able to sober up, celebrated 5 years sobriety (from alcohol) a few months ago. Saved my life.
  
  Congratulations! My wife drinks a ton and has since high school. I make her get blood work done regularly and the worst that happens is inflamed liver.
  She drinks like 3 of those boxes Costco wines a week so at least 2 bottles a day. Sometimes liquor on weekends. She just turned 40
  
  If I were you I'd try to switch off to smoking weed instead. Much healthier, no hangovers, no adverse side effects, and so much cheaper! A chronically inflamed liver leads to some bad things, and dying from it is not pretty or gentle
  
  I don’t drink more than twice a month. I do have an addiction to sparkling water however.
  Maybe I can get my wife to switch though, I’ll try! Thanks for heads up.
  
  Not a chronic weed smoker, but how does weed help? Does it fulfill the same need?
  And isn't this just trading lung health instead (and throat health, though I imagine alcohol isn't great for your throat either)
  
  It fulfills the same need of "something to mark a time of relaxation." while being much less detrimental to your health. Low temperature vaping and edibles are as low-impact as you can get to your lungs. Additionally, even if you opt for actually "smoking" the flower, you're only ever taking a few hits (or if you're like me, on most nights just one!) so it's exponentially less harmful than cigarette smoking.
  
  I believe this is FALSE:
  [she] relapsed into drinking while on the transplant list,
  Where does it say this? I reread it 3 times. That's a huge part of the story and not one you should just make up!
  
  Not made up, I just read a couple other articles that mentioned it.
  It's also part of the whole "the only people who can talk freely are the people with an interest in the doctors being wrong".
  People aren't turned away because they didn't exercise or because they work too much or they don't get enough sleep or they didn't follow doctor's orders. So, in Nathan and Amanda's case, you're seeing someone being told, 'You didn't follow doctor's orders, so we're not going to help you. We're going to let you die'
  As a quote from the other interested party, as well as the "in documents shared with CTV News, notes show [...] their decision was based on 'minimal abstinence outside of hospital.'" is pretty much spelling it out.
  
  ‘minimal abstinence outside of hospital.’”
  I'm not sure why folks seem to think ‘minimal abstinence outside of hospital’ is a smoking gun. That's pretty much how medical staff should document an alcoholic whose sobriety only began while hospitalized. It means she hasn't been able to quit drinking!
  
  In isolation it's not great, but in conjunction with your own advocate talking about you not following a doctor's orders? It doesn't bolster confidence that the individual would follow doctors orders in the future.
  It means she hasn't been able to quit drinking!
  Yes, that's exactly the point. It's quite unlikely her medical troubles started when she was hospitalized.
  A history of not following medical advice casts doubt about a future of following medical advice.
  Yes, addiction is a disease that the individual may lack the ability to control. That doesn't change that it's a risk factor for non-compliance that's absent in others who need the transplant.
  
  whoa wait a minute. I didn't realize which comment i was replying to. I read three different articles and found NOTHING stating she relapsed.
  I do similar documentation and I can promise you that "minimal abstinence outside the hospital" does NOT mean relapse.
  I'm gonna have to ask to see the citation or ask you to delete your comment for misinfo
  
  I re-traced my steps, and the source was both dogshit, and didn't site primary sources. I edited the original comment to convey non-compliance before hospitalization was required.
  Ultimately "was sick, didn't listen when doctors said to stop drinking" conveys the same doubts that "tried to stop but failed" does about suitability for a donor liver.
- Jesus Christ that’s fucked up. Only 36 too and stopped drinking…
  From the article:
  Amanda Huska died Aug. 15 after spending six months in an Oakville, Ont. hospital.
  and:
  Huska, he said, stopped drinking as soon as she was diagnosed with Alcohol Liver Disease on March 3
  So that sounds like she was immediately admitted (which implies she was already very sick) and only was sober in the hospital. In my opinion, that doesn't qualify for "stopped drinking" and unfortunately she didn't get a chance to prove whether or not she was actually able to stop.
  
  How much do you need to drink to get ALD at 36?
  
  It seems the average in the US is 10 years. But you can develop it and reach critical levels in as little as 5 years. Hard alcohol every day. Multiple times a day.
  
  Jesus...
  
  Typically, a huge amount. But genetics may have been an issue, as well.
- I was reading through the article and I think the policy in question is this
  Transplant guidelines in Ontario and much of Canada require patients with ALD to first qualify for a deceased donor liver. If they don't meet that criteria, they aren't considered for a living liver transplant, even if one is available.
  Also this
  "The sicker someone is, the more they benefit from getting an entire liver from a deceased donor, as opposed to part of the liver from a living donor," said Dr. Saumya Jayakumar, a liver specialist in Edmonton and an Associate Professor in the Faculty of Medicine & Dentistry at the University of Alberta.
  "On the off chance their (living) liver doesn't work, they urgently get listed for a deceased donor," said Jayakumar. "We need to make sure that everyone who is a candidate for a living donor is also a candidate for a donor graft as well, " she added.
  As for why that is, I'm not familiar. I've asked someone else and I'll edit in more if I learn more
- Partial transplant from a living donor was not viable for her. It would have immediately failed, leaving her with no liver at all, and then she would have died because she wasn't eligible for a full transplant. Doctors will not perform a procedure that guarantees death. The article explains this
  
  I read the whole article and never saw that
  
  But doctors say that people with severe liver disease from alcohol use may need more than just a partial living liver donation to thrive.
  "The sicker someone is, the more they benefit from getting an entire liver from a deceased donor, as opposed to part of the liver from a living donor," said Dr. Saumya Jayakumar, a liver specialist in Edmonton and an Associate Professor in the Faculty of Medicine & Dentistry at the University of Alberta.
  "On the off chance their (living) liver doesn't work, they urgently get listed for a deceased donor," said Jayakumar. "We need to make sure that everyone who is a candidate for a living donor is also a candidate for a donor graft as well, " she added.
  Guy you were responding to wasn't entirely accurate with what the article says, but general idea is there. If the partial liver fails, then they immediately get added to the full liver list, which is why they need to meet the full liver list requirements. Based on how end-stage she was, it sounds like its less likely the partial would be successful.
- And why the fuck is alcohol taxed so damn high then? I thought that was the compromise.
  
  It's taxed the way it is, because the only drug that kills more than booze are cigarettes.
  Those taxes also go to help innocent people who are harmed in crimes that are often related to alcohol, like domestic violence, assault, and auto-incidents, also things like uttering threats and mischief.
  
  Fair point
  
  domestic violence, assault, and auto-incidents, also things like uttering threats and mischief.
  Crimes most committed by the police?
  
  I agree with the general vibe of police are bad, in Winnipeg they recently killed a woman because they were driving off-road in a park at night, but the idea behind "sin taxes" are generally as a deterrent, as well as a way to try to mitigate damage to others.
  I've been to places that are "cop bars" unknowingly, so the porcine populace may have have a DV-juice problem.

281 comments