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

I've known entirely too many alcoholics that have had too many wake-up and come-to-Jesus moments, only to go back to drinking as soon as the immediate crisis is over. Change only comes when the alcoholic wants to change for their own reasons, not due to external factors.
Livers are a limited resource. Wasting a donor's liver on a person that us is unlikely to stop drinking--despite their protestations--means that another person doesn't get one. It may seem like a cruel calculus, but it's the only reasonable way to ration a scarce resource. It doesn't matter if alcoholism is a disease, or you think that it's a moral failing; the end result is the same.
- This was my initial opinion until I read the whole article.
  "I got my blood tested, I had MRI scans, I had a CT scan, I had ultrasound and blood compatibility test with her. I was a match," said Allan.
  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.
  Her partner was a willing, compatible donor, wanted to give her his liver and was prevented from doing so. So yes, this is a cruel take.
  
  If you keep reading it gives a reason why this is a requirement. Now whether you agree with the doctors or not is up to you but there is at least a reason for this.
  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.
  From this, the reasoning appear to be this: there is a high risk that the living liver transplant will not take. In this case the patient may be at risk of dying instantly and thus need another liver transplant. Since the candidate doesn't not qualify for this other transplant, in the case where the transplant does not take, the patient will die instantly. This is in contrast with the patient being terminally ill however given time to live out the remainder of their life.
  
  Question: are there any countries where this is allowed? Would they have been able to go abroad and do this operation?
  
  As someone else already pointed out, if the transplant from the living donor failed or had complications, now you have two people that need livers. It puts a healthy person at risk for a very low chance of a positive outcome. If they were paying out of their own pocket, then I'd say sure, go ahead, blow your own money on it, risk your own life and health. But they aren't.
- Healthcare is for profit. Doctors, nurses, surgeons, consumables, hospitalization, antibiotics, follow ups all get charged to OHIP at a profit for the healthcare provider.
  If we had actual public healthcare, where hospitals and doctors are not private businesses, maybe we could spend more mony on treatment and rehabilitation for problem cases.
- i think they'd fall under renewable resource
  
  I don't think renewable excludes it from being limited.
  
  IIRC, there are ongoing experiments with organs are being grown in cloned animals; the animal is slaughtered, and the organ is harvested. Maybe someday they'll be more readily available and renewable than they are now.
  ...At least for the wealthy that can afford to have farms of cloned animals.

As an alcoholic, I initially agreed. Don't waste a liver on me. Then this:
Even pleas for a living liver transplant, with Allan offering to be her donor, were not entertained.
What the actual fuck.
- A partial liver transplant wasn't viable for someone this sick, so when the partial transplant failed, they would have to resort to a full transplant from a dead donor, or she would die in operation.
  Since she wasn't eligible, a partial transplant was just a death sentence.
  
  They said it was viable in the early stages, and with a decent success rate. Just not the success rate they wanted, and for some daft reasons you need to be eligible for a full transplant from a dead patient to get a partial transplant from a living donor. Makes no sense.
  
  Liver failure is terminal. She was invariably going to die without the transplant. She wanted to receive the donation, her donor wanted to donate. If the success rate for a living transplant is zero that's one thing, but that's not being claimed here since she wasn't eligible for procedural reasons.
- It’s not like giving away part of your liver is a zero sum game, now that person is at risk of infection, has lesser liver performance, and for what? Someone who has showed they will just continue to harm themselves, and others (the person they’re getting the liver from,) if you allow it?
  I don’t know any other surgeons who would do that.
  
  Has lesser liver performance? What? Do you understand how a living transplant works? You both regrow a full liver after the procedure, because livers are so regenerative you can make a full one from less than half. This makes no sense to me.
  Also she quit for 5 months after she found out she had liver failure.
  
  If a surgeon refused to let me save the life of the one person in the world i love then they wouldn't be able to save any more lives after that so add that to your heartless calculations...
- Takes up valuable hospital times
  
  No. A partial liver transplant wasn't viable for someone this sick, so when the partial transplant failed, they would have to resort to a full transplant from a dead donor. But she wasn't eligible, so a partial transplant was just a death sentence.
- I'd have supported her paying out of pocket to use the live donor that was willing, but not to use my tax money when it's pretty fucking clear she has no intention of changing.
  It's the same reason I'm largely against the Liberal's diabetes funding - ~90% of diabetics are Type 2 (I'm willing to help Type 1's out because it's not their fault) and the vast, vast majority of those are from unhealthy lifestyle even if they are genetically predisposed.
  If were going to have a public health system, people should be required to take care of themselves. And no, I'm not talking about the one-off accidents from riskier activities (although I do think people should bear the cost of their own healthcare if it's the result of criminal activities), I'm taking the problems that occur as a result of abusing your body for years or decades.
  
  You've gotten a lot of downvotes but rather than doing that I want to explain to you why your position here is flawed.
  First think of every lifestyle activity whether it be food, motorcycle riding, music, etc. Now consider that there are some activities that are statistically safer than others.
  If we took your position to the point of being law why would we stop at food lifestyle choices? Why not just any risky lifestyle choices? Eventually you end up with a society where individuals have less choice and freedom and are constantly obligated to live the safest possible lives.
  You and I both know that isn't a desirable outcome. We should be empowering people to live the lives they choose and encouraging them to be healthy, not punishing them for make the "wrong" choice.
  
  What a shitty attitude.
  
  If were going to have a public health system, people should be required to take care of themselves
  On the face of it, this sounds sensible. But, thinking more deeply, who should decide the required amount of care a person ought to take? Ideas about what it means to 'take care of yourself' are varied. And consider that some citizens of this country are simply unable to take the same personal health decisions that others have the privilege to take without a second thought.
  What you're talking about here isn't a public system. A healthcare system that only serves certain chosen people is not public in any meaningful sense.
  A public healthcare system is imperfect on the whole, but on average, when funded and administered properly, is structured to apportion care based on need, instead of the profit motive. I think that's worthwhile, and the right thing for a society to do from a moral standpoint.
  
  Thats a dark road to tread.
  An example,
  no alchol consumption is safe, so using your line of thinking you'd need to argue that anyone who partakes of alcohol at any anytime would fall under that line of thinking
  https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health
  Processed red meats simailary, especially those treated with nitrites, so those eating bacon, ham etc shouldn't be entitled to public heath care under your reasoning
  https://www.cancercouncil.com.au/1in3cancers/lifestyle-choices-and-cancer/red-meat-processed-meat-and-cancer/
  Or are those things ok becase you do them ?
  On the upside, now you've excluded 95% of the population, public healthcare will be cheap :)
  Contra to most peoples thinking, if you're concerned about public healthcare costs, you should "encourage" obesiety and smoking, they all die early, most health care coats are associated with healthy people in their old age. See here
  https://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748884.html
  Adults are stupid and greedy, we all are.
  
  So I drink more pop than I should. Why should I have to pay more for my healthcare than my buddy who had a habit of timing running green lights as soon as they turned green. That isn't illegal, either, yet it's very risky behavior. It didn't work out for him just one time, and he nearly died. Why should taxpayers have to pay for him?
  The answer is because the vast majority of us engage in risky behavior, or just have the bad taste of passing on our poor genetics to the next generation, and the social cost for penalizing people for not agreeing with societal norms are too high. This includes drug use, even legal ones like alcohol. Sure, don't spend limited resources such as donated livers on people who aren't willing to make the lifestyle changes required to make it worthwhile, because someone else will probably have to die for that to happen. But if we could make new livers and the price was reasonable, I wouldn't even be against that.
  
  Until there is a diet that has long term success for a majority of its users I don't think this mindset is healthy or realistic.
  "According to the latest weight-loss research, 95% of dieters end up regaining the weight they lost within two years. Calorie-restricting diets are often successful at helping people lose weight, but they’re very unsuccessful at helping people maintain that weight loss." source
  
  Type 2 diabetes has a stronger link to family history and lineage than type 1, and studies of twins have shown that genetics play a very strong role in the development of type 2 diabetes.
  https://diabetes.org/about-diabetes/genetics-diabetes#:~:text=Type%202%20diabetes%20has%20a,also%20depends%20on%20environmental%20factors.
  Now that you know you were cruel and wrong about diabetes, what do you have to say? What about the type 2 diabetics that have a perfect lifestyle and still have type 2 diabetes?

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?
  
  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!
- 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?
- 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
- 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.

Since no one has mentioned it, USA has the same policy basically.
- And for good reason, really. The supply of livers is too small to save everyone who needs them, so they give them to the people most likely to have a successful outcome. Basically every lived given to one person is sentencing another person to death. That's just reality with supply being what it is.
  
  Their boyfriend volunteered as a live donor. They weren't asking to be put on the general register.
  
  That's not true. Living donors can donate part of their liver.
- Wait, so if someone was ever an alcoholic - they gonna be denied? Even if they stopped drinking for many years?
  
  Doctor here who has referred patients for transplant. No. You must be six months sober to be eligible for the transplant list. There’s so few livers to go around, they need to be sure the recipient isn’t going to just break the next one.
  It’s rare to suddenly need a liver; they usually take months to fail and this gives the patient and doctor months of notice to try treating the failure first (including lifestyle changes and meds) before getting sick enough to go apply for a transplant.
  
  She literally quit when she was told she had a failing liver that could not recover. Just to be clear, there is absolutely no way in hell that she didn't know she was on the way to killing her liver with her drinking because there are a plethora of signs long before you get to the point where alcohol has destroyed your liver beyond its own ability to repair itself. (Which is incredibly prodigious. The liver is the single most regenerative organ in the human body)
  So forgive me if I'm skeptical that she really would have stopped being an alcoholic after she received a liver transplant.
  IMO this was a tragedy of her own making and the money and effort in transplanting a liver would have been a complete waste. (Even one offered by her SO.) Especially when there is such a deficit of available organs and the surgeons who do the transplanting are needed for patients who aren't likely to go back on the sauce 6 months later.
  
  In most places, if they've been clean for 6 - 12 months, they are no longer considered alcoholic in terms of transplantation. Similar to Canada

Hi, transplanted organ recipient here (heart in my case), please be an organ donor if possible, thanks.
- Well I'm signed up, but you'll have to thank me after I actually do it.

There are more people who need transplants than there are organs, so the medical profession has to make decisions about who to deny. This was a reasonable decision, in my opinion.
- I'd be inclined to agree, except that her partner wanted to donate HIS liver and was prohibited from doing so as a living donation due to the alcohol use determination.
- In Canada, drinking more than 3 drinks per week is medically considered "high alcohol use" for a woman... (6 for a man). This limit keeps getting lower year after year
  If this can prevent you from getting organ transplants, then it encourages lying to your medical doctor about your current habits... That lady was not considered alcoholic, she just used alcohol in greater amount than the limit considered acceptable by doctors.
  Latest stats show that almost 4 out of 5 people has exceeds that limit at some point in their life. This woman died only because she was honest with her doctor about her alcohol use. (Note that the article says her partner was a compatible donor but the system refused to accept him because she used alcohol. It's not about lacking donors.)
  
  This woman died only because she was honest with her doctor about her alcohol use
  No, and it even says so in the article
  She quit about 5 months before her death when transplants require 6-12 months of sobriety. She was drinking regularly with the fucked up liver before that diagnosis, and liver damage isn't something that just suddenly appears.
  She kept drinking despite what would have been intense cramping pain and a slow death, thats why she was denied (addiction) and ultimately died
  Note that the article says her partner was a compatible donor but the system refused to accept him because she used alcohol
  And as the article also says it's incredibly dangerous for someone to get a live-donor transplant when they're in bad shape like she was, as failure of that means they'll need to let her die on-table or transplant a good dead one into her (which she was denied for, due to her drinking)
  It's sad, but this woman died to alcohol abuse, pure and simple
  
  That's total bullshit. As a IT professional I have a nightly drink after work for self medication. Never two. Just one.
  
  The only genuine hint to the real reason of the refusal was "minimal abstinence outside of hospital".
  Let me ask you bud, if you needed a liver transplant to continue living, would you have even one drink per week, or would you just quit completely?
  Very biased article.
  Plus, regardless of her husband being compatible, it still costs the state tens of thousands for the operation. In no way would it be ethical to put a new liver in someone who refuses to completely abstain from alcohol.

I'm quite torn on this issue, my sister donated her kidneys and liver when she died. On one hand people who need an organ, need an organ but on the other hand deceased persons organs are so rare that they should go to those with liver diseases they have no medical control over before those who are sick from an avoidable disorder.
I don't like to think of my sister's liver going to someone who would abuse it over someone who just happen to have a genetic liver issue. She lived a life too short bringing joy and education to many children, her final act saving others would be soured by someone wasting it.
- I guess you can also think of alcoholism as a disease too?
  
  I completely agree that alcoholism is a disease, and as with any other disease, we have to look at the survivability if she got the transplant.
  Let's be honest, while the article tries to be favourable to the patient, you can piece together the facts and see that her odds weren't good. While she's been sober since she got the diagnosis, it appears she was immediately hospitalised which tells us she was in very rough shape and has only been sober while in the hospital. Even if she was able to stay sober, it looks like the odds with a partial transplant aren't great.
  
  Some could consider it a mental disorder.
  Compared to an autoimmune disease that attacks organs and glands, I'd think the autoimmune patient should be top of the list. Probably good that I'm not on death panels though.
  
  It is, or at the very least is a symptom of another one. I have all kinds of addiction issues which is why I must be super careful in my life. I am a former alcoholic who used to drink nearly every day from basically after work until I was too tired to keep going. I also have ADHD and possibly ASD (the latter not officially diagnosed as of now). There seems to be some evidence that those can play a role in addiction.

Maybe if donating organs was compulsory they wouldn't be so rare.
- In my country, everyone is an organ donor unless they specifically opt out. Usually due to religion.
  I've been seeing organ transportation ambulances near my city's hospital from time to time. It's weird to see, but a good thing.
  
  There should be no opt out, even for religion. No I do not respect your customs as much as I respect someone else's life.
- They still need to be a match
  
  Imagine how many matching organs are just left to rot in the ground.
- Why not? Why do you need the ability to deprive someone of a live saving procedure after you literally died?
  
  Do you mean opt in by default?

As grim as it might be, transplants are handled by apathetic, risk averse math and little else. Loose organs and surgeons are far from common.
- Like killing disabled people because it's cheaper, farming slaves to provide cheap labour, that sort of thing?
  There a good reason we tend to prefer the more humane and emotionally guided solutions over the mathematically most efficient.

My cousin was a raging alcoholic. He got clean, but not before he fucked his liver right up. I don't know if they even allowed him on the liver transplant list or not, but if he was, he was very low on it. He died in early 2015 at the age of 43.
- How long was he drinking? And how much?
  
  He'd been drinking since he was a teenager, and he'd sometimes get blackout drunk, getting arrested for public intoxication, etc.

Well this was informative. I will now start lying to my doctor about my occasional alcohol use.
- Or maybe read the article?
  Occasional alcohol use won't put you in this situation (hopefully you'll never be in this situation for any reason)
  However, of the reason you need a liver is that you wrecked your own with booze; you are unlikely to get another one
  
  I didn't see in the article if she self-reported alcohol use, or was tested. I'm responding to the comments here about self-reporting.
  
  Same for all the people who eat nuts and get hospitalized as well, pull the plug right? I mean come on, they are lesser humans as we stand on our pedestals and look down on them. /S
  Genetics play a huge role in liver diseases. 85% of liver replacements don't come from alcohol. Alcohol in sure is bad for you, but it really is a high horse scenario.
- According to the Summary Statistics provided by Canada at THIS LINK, Notably Tables 2A and 2D.
  473 were simultaneously on a wait list in December 2023 and either 7 or 8 of them died awaiting transplant (or maybe gave up voluntarily).
  So I'm not saying it's murder or anything, just that in order to prolong your selfish existence you're directly responsible for the death of another. You're an adjacent-murderer.
  But it's impossible to know how many livers are or are not available at any given time, so absolutely a little morally ambiguous.
- Lying about substance use to a confidential healthcare provider is not going to do you any good. If you have drank so much that you are having liver failure, they will know you are lying. If you haven't drank that much, what's the purpose of lying? To perpetuate the addiction?
  
  In case I get liver failure for some reason other than drinking, but get disqualified for answering incorrectly.

Giving a donor liver to an alcoholic, who only quit drinking upon diagnosis? Hell no. There are people with 5+ years who still worry about relapsing. A year is a start. Being forced to quit? I'd have wished her good luck if they gave the liver, but the person who dies instead of her?
I've watched alcoholics die of liver failure. It is a horribly sad thing. But sobriety is a choice, and you don't get to go back in time to make it. I'm not sure why this article is spinning this as cruelty from the transplant board instead of maybe, just maybe, highlighting the destructive role that alcohol plays in society. I wonder if a booze company pays their bills or something.
- Did you bother to read the article? Her partner was a match, and could have donated a portion of their liver to her, if approved, as opposed to a donated liver.
  Judge someone all you want for their previous life choices, but the decision referenced in this case should have been between the two of them and their doctor.
  
  Did you bother to read the article?
  Did you? Her liver was so far gone, doctors did lot believe a partial transplant would work
  
  Yes, I read the article three times over, trying to chase down false info someone posted in here. His offer is irrelevant. The prognosis was not good enough for him to donate. They only included it in the article for the melodrama. It's nothing more than an "I would die for her!" moment. Well, I'm glad the medical board did not condone assisting him with suicide.
- That would be nice if we had an unlimited supply of livers to transplant. Give everyone a chance.
  Unfortunately I'd still rather give whatever liver we have on hand to someone guaranteed not to wreck it immediately, because giving her a chance means taking away someone else's.
  
  I completely disagree. People should be able to make mistakes.
  You are allowed to make mistakes... What you are not allowed to do is skip the consequences
  It's not like you can pick a liver at Walmart and give it a try. That liver could save someone else, giving it to an alcoholic is likely to only buy her a tad more time untill she relapsed
  
  Medical notes suggest she started drinking in her late teens and had tried -- unsuccessfully -- to quit. After periods of sobriety, she returned to alcohol, which could increase the risk of continued use after the transplant.
  Allen says Huska registered for an addiction program early on in her hospital stay to stop drinking after she's discharged. Hospital records also say she suffers from anxiety.
  From the first article CTV made about this, linked in in the first sentence they posted. Seems like we need to actually fund mental health care in this country or something, because she's obviously been struggling for a while. You can see how the board would weigh previous failed attempts to quit against her.

I donated a kidney to a friend earlier this year. The reason his kidneys failed wasn't anything he was at fault for, but even if it had been because of poor decisions he'd made in the past, I still would have given him one of mine. Because people deserve second chances. I can understand not wanting to give a recovering alcoholic a deceased donor's liver, when someone else could receive that liver, instead. But this woman's partner was a match and was willing to donate to her. What's the harm in that? That isn't a liver that could have gone to someone else who needed it. It's a donation that would have either gone to her or no one else. No one could have lost out of the donation had been carried out. This was just cruelty, and now someone is dead. And for what? Because there's a 15% chance (according to studies the article mentioned) that she might have started drinking again???
- It's not super clear, but the article makes it sound like if a partial graft from a live donor fails, then the recipient is automatically fast tracked for a new transplant from a deceased donor.
  If that's the case then maybe policy should be changed in the case of alcohol abuse.
  
  The policy isn't there just to be extra nice, it's because otherwise the patient dies without a liver.
  Since she was too sick for a partial liver transplant, and not eligible for a dead donor full liver transplant, she would have just died.
  It might seem cruel but the same is done for a lot of other procedures; if the chance of you dying in surgery is way too high, doctors won't take the risk, they're not executioners.
  It's not a moral judgement about her alcoholism, the same would have been true if she had a cancer no surgeon would take on.
- Surgeon time is precious as well.
  
  In the article, it shows that the hospital spent significantly more slowly letting her die than the average cost of the transplant.
  
  So let the free market sort out the organ redistribution problem!

It's incredibly sad to hear someone die of a preventable cause this young, but I can also somewhat relate with the people who reviewed her application.
If a living donor wouldn't have been sufficient, they've now created two patients where they previously had one, and without improving the primary patient's condition. It makes sense that a donor organ from a deceased donor would be preferable.
That said, the current requirement for the patient to meet deceased donor standards for transplantation to be eligible to use a willing living donor make no sense. Both situations should have their own unique criteria, given that a living donor situation involves different risks for both the patient and the donor than a deceased donor situation would incur.
Ultimately this whole situation boils down to a scarcity situation though. If we want to solve this, it will require more people to register themselves as a donor and a review of the eligibility criteria as soon as more donors are available.
- And how prevalent and socially acceptable Alcoholism has become.
  
  It's not just acceptable, it's encouraged by the province to keep people from rage quitting their lives here.

How has Polievre not tried to capitalize on this tragedy to pitch his "your bank is a better death panel than the transplant math" plan yet? American healthcare is half his platform!
- He has a platform? Every time I check is just angry "I'm better than Trudeau" statements
- As a former American, you do not want the American Health Care System unless you are very wealthy. It is an expensive bureaucratic disaster. BC Health may be imperfect but at least I am not paying us$700/month for family insurance that might be accepted by the doctor/hospital that sees me in an emergency.

The provincial governments in charge of our single payor health care system made the conscious decision to keep the liquor marts open while banning in-person sales of tea kettles (and we call ourselves a commonwealth nation!) during a pandemic.
I think our single payor at least partially did this to themselves.
- I'm pretty sure people would've stormed parliament if you banned alcohol sales.

If you are going to make alcohol consumption a bar to a liver transplant without making alcohol illegal you should all go fuck yourselves. You had a drink and you should die should not be a thing.
- This isn't what happened though. She was addicted to alcohol, per her partner, got diagnosed with needing a new liver, she immediately quit alcohol, and they denied her anyway even though quite a bit of time had passed while she was sober. I am unaware if her liver disease was because of the previous regular alcohol use. It wasn't just 1 drink though.
  Yes, organ donation is messed up. I met a girl dying in hospice once. She needed a new kidney. Genetic stuff, and then when she was 15 she tried to kill herself with Tylenol. She got her first transplant before the suicide attempt. She was denied a second one due to the suicide attempt itself. There are only so many organs in the world. She died in agony in hospice, young and covered in calcium deposits.
  We punish substance use and mental health so harshly in this country. No one deserves the death penalty for previous substance use, especially for alcohol which is ancient af. It's horrible she was denied when there was a liver already available.
  
  It's horrible she was denied when there was a liver already available.
  Any full cadaver liver that could have gone to this woman didn’t get thrown into the garbage — it went to someone else who would have died without it.
  As for the living donor liver her boyfriend offered, even though he was a match her level of liver failure likely meant that the partial liver her boyfriend could have donated wouldn’t have been successful. Living donors still need a liver for themselves, and we each only have one full liver — so the best they could have done is given her half a liver. Her condition was too poor for this to have a likely positive outcome, which was why this was also denied.
  It sucks, but there aren’t enough donor livers for everyone who needs one. The cadaver liver she was denied however would have gone on to save the life of someone else you’re not hearing about in the press — someone else who may have died without it.
  If the unfairness of it all upsets you that much, then make sure you’ve signed your organ donor card, and make sure your family members know and understand your desire to be an organ donor. And encourage the people you know to do the same. This is only a problem because there aren’t enough donor livers for everyone — when you have n livers, at best you can save n lives — and thus having a larger number of donor livers allows for more lives to be saved, with fewer qualifications.
  
  From my limited knowledge organ donation criteria are horribly restrictive on a personal scale but unfortunately make sense on the macro scale. Organs are such a scarce resource that as I understand there's no other option.
  This girl's death was undoubtedly a tragedy, but as fucked up it's to say if she lived someone else would probably die in a similar agony. Was she treated fairly - I don't know, can we make this system better - I unfortunately also don't know.
  
  We punish substance use and mental health so harshly in this country
  It's not punishment, any chronic illness will make someone ineligible for an organ transplant. It's not saying it's that person's fault, it's a situation of "2 people need this organ, which ever you choose the other will die in agony, one is more likely to live twice as long as the other."

Using the most recent data from the Canadian Institute for Health Information on hospital bed costs (2016), Huska’s time at the Oakville hospital likely cost over $450,000 - ($3,592 per day for ICU care) with an additional 61 days in a ward bed which likely cost about $1,200 a day A liver transplant in Ontario is pegged at about $71,000 to $100,000 in Ontario based on data from 2019.
I've come to the realization the only ones getting us off the dark timeline is us. I'm in USA, ready and willing. Thinking through what beginning steps I can take.
- I didn't like the cost section, because it felt simplistic. The actual procedure might be "cheaper", but it doesn't take into account the long term costs if something goes wrong with the "cheaper" option. Living liver donation is different from say a kidney, you're taking a part of someone else's liver.
  "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.
  I worry people are going to see those numbers and run with them, even though there's more to consider than that. Financial calculations in medicine are always difficult, and it feels dirty no matter what
  
  The article is not clear. Is the $71k price listed the cost of the surgery itself or surgery + hospital stay?
  If it is just surgery then it is a very unfair comparison since the ICU stay would have been needed in either case, and at least some of the days in the ward for recovery.
  
  So some rough numbers I found from places online for rough estimates. Also, the link the article has for bed costs is actually to a study on liver transplant costs.
  On average, 25 days in hospital between pre/post transplant. Of that, seems like a few days (varies by person) is in ICU. So thats 50 days of beds for the two of them, with say a week of combined ICU time.
  Plus two surgeries - the article only takes an average cost of liver transplants, which is not indicative of a second surgery needed for a living donor transplant.
  That puts the cost up to ~240,000-300,000. That cost is close enough that I can see it not being a factor for the decision.

How come we've managed to make artificial heart but not artificial kidney or liver?
- Pump make blood go weee
  Liver and kidneys have to filter and sort various chemicals to keep them from poisoning your body.
  Also, dialysis is a thing, it's just generally external cause of the complexity.
  
  Artificial kidneys are in the test phases. Not sure when they’ll enter trials but it’s very complicated.
- The liver is one of the most complex organs in the human body. It is responsible for a wide spectrum of toxin breakdown and chemical synthesis. The heart only needs to pump blood, though it's uptime is very impressive. If your liver stops working you won't die immediately but if your heart stops working your body will be starved of oxygen in mere minutes. Ultimately though what the heart does is mechanical and simple.

Somehow I read the article thinkingshe had a kidney problem which we have two of.
How can her boyfriend even donate his liver? Wouldn't he die?
- Something interesting about the liver is that we can regrow it. So it might be possible to take a portion of a liver, put it in another person, and then both those pieces grow into a full or well-enough-functioning liver. I'm not a physician and I don't know if such a procedure has ever been attempted.
  
  I believe that's an established procedure. Both the donor and the recipient regrow full livers from the portion they have. You can only donate once though because of how the new liver tissue is structured. I believe the arteries in the new one aren't in the same place.
  Edit: if you read the article it actually tells you her boyfriend was willing to be a live donor.
  
  maybe this is a joke going over my head but you just described a liver transplant. what blew my mind was learning that they don't take the old liver out, they just squish the new one(the healthy liver sliver if you will) in and let it do it's thing

Using the most recent data from the Canadian Institute for Health Information on hospital bed costs (2016), Huska’s time at the Oakville hospital likely cost over $450,000 - ($3,592 per day for ICU care) with an additional 61 days in a ward bed which likely cost about $1,200 a day
A liver transplant in Ontario is pegged at about $71,000 to $100,000 in Ontario based on data from 2019. "It's a shame that so much money was spent keeping her alive under such horrendous circumstances and putting her family and her partner under such stress when the remedy was a lot cheaper and could have happened much, much sooner," said Selkirk.
The survival rate of patients with alcohol-related liver disease who receive a deceased donor liver transplant has steadily improved to reach 80–85 per cent at one year after a transplant.
Can anyone make this add up?

@NightOwl brutal

I thought this was about kidneys instead of livers and was very confused.

Selkirk said she and Allan are both discussing a legal challenge to the liver transplant guidelines for those with alcohol use disorder “with people who have their own living donor.” “It's not fair and it's not right, and hopefully we'll change that policy,” Selkirk said.
Even if her partner could donate his own liver, it should still go to a better recipient. If anything he should be donating anyways to honor her and save a life
- Even if her partner could donate his own liver, it should still go to a better recipient
  That's nonsense, because the partner would not donate his liver if it went to someone else.
  
  Right? Like I would donate my liver to my kid, or my spouse, without even questioning it.
  But if the doctor told me they can't have it (for some reason other than incompatibility), and they died? Fuck them. I'd de-register as an organ donor out of spite.
- You (or the committee of doctors) don't decide who is a better recipient for my goddamn organs. You can make whatever the fuck ethical decision you want when I'm dead, but not until then. And I've gotta say, it's shit like this - treating patients & donors like you know better - that make me not want to be a donor anymore. If I wanna donate my lungs to Hitler because he's my grandpa and I love him, that's not something you get to have a decision on.
  
  The fact that people are down voting you for saying in essence “my body, my choice”, is ironic for lemmy.
  
  Doctors are cops. Pass it along
- Maybe he should, but maybe he is thinking "Fuck them, we tried to participate in the system. We had a living donor to go. What? Oh you have a 'better' recipient? Well, guess who doesn't want to donate to a system that failed my loved one."
  
  The system didn't fail, it worked as intended. If but mid 30s you've destroyed your liver with your alcohol addiction, it's almost guaranteed you'll slide back.
  Recipients can't drink ever, and have to take meds for life. She was not a good candidate for a transplant.
- My apartment only bring me debts.

- it's* their fault