Transplant questions

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firemantino
New Member


Date Joined Apr 2010
Total Posts : 2
   Posted 4/18/2010 9:53 PM (GMT -7)   
My mother has been diagnosed with cirrhosis and is going through the process of being put on the transplant list. I'm looking for any info on how her background may or may not be evaluated by the transplant center.
Mom has been an alcoholic for 3 decades. Her liver disease was discovered because she developed esophageal varices last December. She had an upset stomach and didn't drink for several days prior to vomiting blood, so she did not have any alcohol in her system when she went to the ER, and hasn't tested positive for any alcohol since then. She has shied away from doctors for years, I am sure none of her doctors know about her drinking problem.
I know that her alcoholism would keep her off the list for now, and I don't want to be the a-hole son who "throws her under the bus" by asking questions of the medical staff ( yet ) but the notion of her possibly receiving a transplant over somebody else really bothers me.

Does the transplant evaluation process look for this stuff?

Any thoughts on bringing it up myself?

arneeb
Veteran Member


Date Joined Nov 2009
Total Posts : 2350
   Posted 4/19/2010 2:06 AM (GMT -7)   
First of all confidentiality is an issue.. your mother's... she has the right by law to confidentiality... secondly.... some treatments could kill her with drug interactions... and do you know for a fact that she is drinking currently??? I would know the facts before taking such a drastic step... those tests are extensive... and if she's drinking I believe the doctor's will figure it out... however if not knowing puts her life at risk... I think that's at the point where u can legally intervene...if her life is at risk... the question is she still drinking... and then go from there... is she her own guardian... and a transplant team will figure it out... pretty quickly through testing and it's not just a simple test.. they will find out... it's not that I don't agree with your moral argument... but just because she's drinking doesn't mean she loses her legal rights to privacy and HIPPA rights.... rights to confidentiality... I believe if she is drinking she will be found out pretty quickly...

**David**
Veteran Member


Date Joined Nov 2009
Total Posts : 3708
   Posted 4/19/2010 6:58 AM (GMT -7)   
I've been through the transplant process. Your mother may be able to get through it, if she's quit drinking. If not, they'll likely catch her. If she isn't drinking, getting a liver ought to be fine. What most hospitals are worried about is people receiving a liver and using it as an excuse to go back to drinking because they're "OK." **David**

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 4/19/2010 10:53 AM (GMT -7)   
Hello, Firemantino, and welcome to the forum.  Regarding your mom's alcoholism, I assume that's why she has cirrhosis.  The doctor who diagnosed her undoubtedly knows that and the transplant evaluation docs will, too.  Even if she is not drinking now, given the cirrhosis and the cause of it, they may very well require 6 months of DOCUMENTED sobriety through either AA meetings or alcohol counseling (depends on the particular transplant center.)  I don't think you are going to have to say anything regarding her alcoholism.  They will know and they will also know if she is currently drinking.  You say she has tested clean from alcohol...for how long?  If she has not been drinking since Dec., she might slip by.  Lifelong alcoholics are not usually able to stop drinking completely on their own. 
 
Who gets a liver depends on a MELD score, which is determined by values of serum creatinine, INR, and serum bilirubin.  Transplant recipients normally are scoring in the mid to high 20s when they are transplanted.  Some conditions, such as cancer or seizures, can add points to the score.
 
hep93
Forum moderator - Hepatitis
 
"But that was yesterday, and I was a different person then."
Lewis Carroll, Alice in Wonderland


firemantino
New Member


Date Joined Apr 2010
Total Posts : 2
   Posted 4/19/2010 9:34 PM (GMT -7)   
Thanks for your feedback.  She has been diagnosed with alpha-1 antitrypsin deficiency and  auto-immune hepatitis.  The Alpha-1 generally affects the lungs long before the liver.  My mom's cirrhosis is most certainly due to alcohol, but because she has tested clean and has lied about her alcohol use she is being evaluated for the transplant list as a "one in a million"  Alpha-1 case.
 
Her MELD score is 22.  It was 20 two weeks ago.  She has developed diabetes, ascites and mild encephalopathy, and varices since December.  She is very jaundiced as well.  Her health has dropped off rapidly in four months, and I really don't know how long she might last.  She has another round of tests at the hospital next week.
 
I'm not necessarily hoping they find out about her drinking or pushing to get it out in the open, just morally torn about the fairness of her getting a transplant while others don't.  I'm certain that if she "sneaks by" and gets a transplant she'll resume drinking.

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 4/20/2010 11:46 PM (GMT -7)   

Firemantino, this is a tough call for anyone.  If you feel certain she will drink again after getting a new liver, I personally would let her drinking history be known to the transplant team in some way, along with your feeling that she would drink again after a transplant.  But this is something you must come to terms with yourself.

Hugs,

Connie


hep93
Forum moderator - Hepatitis
 
"But that was yesterday, and I was a different person then."
Lewis Carroll, Alice in Wonderland


shadowsghost
Regular Member


Date Joined Apr 2008
Total Posts : 489
   Posted 4/27/2010 8:21 PM (GMT -7)   

Firemantino, I am sorry you are having to deal with these issues, your mom being so sick and the drinking concerns. Sad to say some people do go back to drinking after getting a new liver. I wish you all the best with helping your mom and trying to figure out what to do. It will not be an easy road to travel, you will do what is best for her and you I am sure.

Sue


When I started counting my blessings my whole world turned around.

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