The United Kingdom may have a shortage of organ donors to meet the growing demand for liver transplants in the country but this did not stop the NHS Blood and Transplant Service (NHSBT) from launching a controversial program that will provide liver transplants to heavy drinkers with severe liver disease.
The NHS plans to recruit 20 people with alcohol-related hepatitis for transplant and evaluate the outcomes. Under the pilot scheme, individuals with severe alcohol associated hepatitis (SAAH) who were previously excluded from transplants can be considered so long as they are not more than 40 years old and they have not already been diagnosed with liver disease and drinking problem.
People with SAAH were not previously considered for transplant because they are often already very ill when they first see a doctor so they were considered less likely to survive the pre-transplant abstinence period. A 2011 French study published in the New England Journal of Medicine, however, suggested that early liver transplantation may improve the survival rate of some SAAH patients.
"We are looking at a small group of people in the UK who are eligible for the scheme and we want to see if the results we get are similar to those of the French study," an NHSBT spokesperson said.
The move, however, is igniting debate as to whether people believed to have inflicted the liver disease on themselves deserve to have the costly treatment. Besides the shortage of donors, there are also concerns that people would be reluctant to donate to patients whose liver disease was due to excessive drinking.
Professional football player George Best, an alcoholic for most of his adult life, had a liver transplant performed at the expense of the NHS in 2002 but he went back to drinking alcohol after his operation. British Liver Trust chief executive Andrew Langford said Best's case makes people apprehensive of donating organs to alcoholics. Some people would also want to ensure that the organ they donate does not go to someone who cannot take good care of it.
NHSBT associate medical director James Neuberger said that the service is aware of the implications of its decision but noted that the program will be worthwhile.