Alcoholics who are suffering from severe liver disease are soon going to be allowed to have transplants on the NHS for the first time.
The scheme is bound to be controversial because there is a national shortage of suitable organs for transplant — and critics will say those who bring ill-health on themselves do not deserve such help.
The decision by NHS Blood and Transplant Services was announced on April 3rd and will affect those with severe alcohol-associated hepatitis’ (HAAF), who have been excluded from transplants due to poor prognosis.
James Neuberger from NHSBT told The Guardian, “We transplant humans, not angels,” in regards to the fact that people may not be willing to donate if they know their livers may go to such patients.
The project comes amid concern for the rise in deaths from alcoholic liver diseases – at a time when deaths from other conditions were decreasing. While alcohol consumption is a deteriorating trend across most of Europe, it has soared over the past 50 years in the UK.
Doctors say liver disease victims are getting younger by the year, but cases of the condition are rising most quickly among the over sixties. At present, people are usually only considered for transplants if they have a more than 50% chance of survival after five years, with a good quality of life.
Alcoholics are required to show that they will be able to give up drinking for the rest of their lives.
However, about a fifth of liver transplants involve patients whose conditions have been linked to their drinking, including the late footballer, George Best.
Commonly, there isn’t sufficient time to judge the prospects of SAAH patients giving up alcohol, and they often suffer infection and bleeding as well as have deep jaundice and mental confusion.
The patients intending to be treated under the pilot scheme must be between 18 and 40, and must not have seen a doctor about liver disease or been diagnosed with a drinking problem before.
There has been concern amongst transplant specialists over the number of candidates they may have to assess – and the impact on other patients awaiting organs.
Neuberger said: “We need to retain public confidence that organs donated are used properly. That trust has to be earned – it can be lost very quickly.”
The latest rethink was prompted by a study in November 2011 which reported six-month survival rates of 77 percent among SAAH patients who received a new liver.
[Source]
