Because you know this will cause controversy

[mr friendly guy]

linky

I would have posted this yesterday, but for some reason I couldn't get the board homepage to load up on either firefox or IE

Dying drug addict refused second liver transplant

Claire Murray is a 24-year-old mother of two who has only months to live if she does not have a liver transplant, but she is being refused a place on the waiting list for a donor organ.

State will pay: Hames

Father will risk all for daughter

Her family knows her case will polarise views because she has abused heroin in the past.

She even took drugs after her first transplant last year to treat acute liver failure caused by 12 years of addiction to amphetamines and heroin.

That donor liver has now failed, and doctors at Sir Charles Gairdner Hospital have told her parents, Michael Murray and Val Milne, they cannot consider her for a second transplant.

Ms Murray's family accepts she continued to abuse drugs after the surgery but argue that the success of the transplant may have been limited because of issues with the surgery and inadequate rehabilitation.

Nationals MP Vince Catania and Labor MP Martin Whitely are campaigning for the mother of Chloe, 5, and Taj, 4, to be given another chance.

Mr Murray said yesterday his daughter had been a happy and healthy A-grade student at a Perth private school before being diagnosed with attention deficit hyperactivity disorder at age 12. She was prescribed dexamphetamines and began abusing the drugs, later moving on to speed.

"We feel one thing led to another, and ultimately her addiction, and that's when our problems began," he said.

Mr Murray said his daughter had been on the methadone program before her transplant and was deemed fit for the surgery but he did not believe she was properly followed up to ensure she did not continue to abuse drugs.

Ms Murray's mother had given up work to support her and she had been clean of drugs for eight weeks.

"She now has three to six months to live," he said. "We're very aware that if Claire goes back on the list it doesn't mean she's going to get one and it's not necessarily going to save her life. But everyone deserves another chance."

Ms Murray said she felt far more prepared and determined to make the most of any chance she was given.

A SCGH spokeswoman said the hospital operated a world-class liver transplantation unit that met Transplantation Society of Australia and New Zealand protocols for eligibility and had exceptionally high survival rates.

It denied that surgical care or post-operative treatment were lacking or contributed to Ms Murray's outcome.

Late yesterday, Health Minister Kim Hames said Ms Murray did not meet national guidelines for a transplant and it was not reasonable to provide an organ to her when there were seven West Australians waiting for their first transplant.

He said 19 liver transplants were carried out in WA last year, and three people died waiting for a new liver.
But he said the State Government was prepared to pay for his Mr Murray and his daughter to go to New Zealand for the case to be reviewed by a specialist experienced in "live" liver transplants, which used a piece of a liver from a living family member.

health department is willing to pay her to go to NZ to be assessed for live transplant

father take the risk of live transplant for daughter if compatible

Of course chances of getting a live transplant are slim anyway because she has to meet the same criteria as a cadaveric transplant.

And just so you know that this is the West Australian, lets have This

Daughter angry dad did not get a chance
LISA CALAUTTI, The West Australian February 26, 2010, 2:30 am

Ellysha Morgan-McArthur can't help but wonder what would have happened if her late father had received the liver that doctors gave to Claire Murray last year.

The young mum is outraged Ms Murray is asking for a second liver while her father died while waiting for a transplant.

Mrs Morgan-McArthur's father, Michael Kane, was in a hospital room across from where Ms Murray was recovering from her first liver transplant.

"Just to know she is going for another one, when my Dad could have just had one," she said. "It could have lasted him another 10 or 20 years. It's just heart-wrenching. You think, 'Girlie that was such a gift the first time and here you are asking for another'."

Mrs Morgan-McArthur's father died one month before Christmas from cirrhosis of the liver and cancer. He had been on the organ transplant waiting list for about five months.

The 52-year-old had battled illness for four years. He would have loved to see his two-year-old grandson Seth grow up, Mrs Morgan-McArthur said.

She said while her heart went out to Ms Murray and her family, she felt sick to the stomach to think her father could have had Ms Murray's first liver if it was found to be a match.

"I can empathise because she has got kids. However, we all make choices, we all make decisions and we all do make mistakes," she said.
"But, there comes a time where you realise that there are only so many you can make and there are other people more willing, or more worthy out there."

If online comments from this site and elsewhere are any indication, it certainly has polarised people

Ok, lets get some of the confusion out the way.

She doesn't meet the criteria for being on the transplant list so she isn't. The government has offered to pay her to go to NZ which does more life transplants, making this a special case. Problem is it appears they are wasting their money because she still has to meet the same criteria. The sticking point being she has to be off drugs for a certain length of time, IIRC six months. She hasn't. Doctors suspect she will be dead by then.

Unsurprisingly there are people threatening to take themselves off the organ registrar over this (at least they claim to online) even though SHE ISN'T BEING PUT ON THE WAITING LIST.

Then there are those who complain that organs are given freely and bitching about one potentially going to her are hypocrites. Well actually it is a bit more complicated than that. Whether they know it or not, organs aren't just given to any match. There is still a criteria for selection, so when people donate the organs it isn't quite as freely given (as defined as anyone can receive it), so these people are right to complain that she wants an exception for her to go on the wait list when she doesn't meet the criteria.

People appear shock that some of the transplants recipients are ex druggies? Sheesh we better keep quiet about that or else the transplant list will be down.

Now I have a sticking point

Ms Murray's family accepts she continued to abuse drugs after the surgery but argue that the success of the transplant may have been limited because of issues with the surgery and inadequate rehabilitation.

1. Presumably she must have already been drug free for a length of time before the transplant so its tough to blame inadequate rehabilitation. The fact that someone doesn't stay off drugs indefinitely doesn't equal health services were inadequate. Not all treatment works especially in cases where people simply have to take some responsibility for their own goddamn actions.

2. Issues with surgery? I love this generic attack, blaming the doctors who actually helped her in the first place. Could they be any more vague? Which issues with surgery do you blame for transplant failure? Its like they know a lot of conservative Western Australians won't take this well especially with the drug abuser tag, so they try and blame the doctors.

Just for the record, I don't have a problem with being an ex abuser. The problem is a current abuser because you will decrease the chances of a transplant succeeding. Saying you are an ex druggie because you were off it for a short time is about as disingenuous as a man saying he is an ex smoker because he last smoked yesterday.

[Anguirus]

Considering that most people die waiting for one transplant, it's pretty hard for me to defend giving a second transplant of the same organ to someone who--without trying to be morally judgmental--is quite likely to fuck it up AGAIN.

There's no reason for hysteria (even if she got on the list she's pretty much fucked). There's also no reason to give her money to fly anywhere. If I may use a tasteless analogy, it's like giving your extra life in a video game to that dude who you know is just going to deliberately jump off the cliff and die again, because he did that the last time.

Bottom line: there are fewer organs available than people who need them. No one should get two until everyone's getting one. I know it's more complicated than that what with matching tissue types, etc, but I doubt there is likely to be many situations in which ONLY she could be saved by an available liver.

[CaptainChewbacca]

If you are currently treating your body like a chemistry set YOU DO NOT GET NEW ORGANS. Its that simple. The same rules are here in America. Its not perfect, and some might not call it fair, but there's no FAIR way to distribute a limited supply of organs that everyone needs.

[Lord of the Abyss]

I would have posted this yesterday, but for some reason I couldn't get the board homepage to load up on either firefox or IE

The board was down for over a day, no one could get on.

[Gil Hamilton]

I'm surprised she got the first one. I thought hospitals were so short on good organs that they wouldn't put one in someone who ruined their last one with drugs on the grounds that there was a not-insignificant chance they'd relapse and do the exact same thing to the new one.

[K. A. Pital]

Drug addicts should be banned from getting organs. Period.

[mr friendly guy]

I'm surprised she got the first one. I thought hospitals were so short on good organs that they wouldn't put one in someone who ruined their last one with drugs on the grounds that there was a not-insignificant chance they'd relapse and do the exact same thing to the new one.

There are criteria to try and chances to demonstrate that they won't relapse, ie they have to stay off drugs for a certain length of time. I vaguely remember that statistically chances of relapsing improves the longer you stay off it, but it never reaches 100% (yep someone did a study on that). She most probably met the criteria the first time and was judged as likely to get greater benefit, than compared to say an older person (in terms of years of life left, better ability to tolerate surgery etc).

I have to say though, some transplant / potential transplant liver patients I have seen in my hospital, did once upon a time fuck up their livers. For example hepatitis B or C through IV drug use. Problem is that was a long time ago and hepatitis takes decades to do its damage. By then they are older, hopefully more mature and certainly off drugs for a long time. Most of which doesn't seem to apply to her.

[Chris OFarrell]

In a perfect world, where we have plenty of organs for everyone, she should of course get one.

It isn't, we don't, she HAD one and fucked it up, she simply doesn't deserve another one when there are other people who have not HAD a transplant and are far better candidates in health terms.
Is this a sad situation? Of course it is.

But she HAD her chance where many others missed out and died, and she blew it. Game over. That simple.

[ray245]

I thought that opt out programs will resolve the problem with a lack of organs?

[CaptainChewbacca]

I thought that opt out programs will resolve the problem with a lack of organs?

Theoretically, but its still a limited supply. And the world's largest supply of healthy and easily harvested organs (the United States) only has an opt-in program.

[Alyrium Denryle]

As far as I am concerned, Fuck Her. Right in the ear. She fucked up the liver she was born with, then she fucked up the one she was given. If she relapsed after six months the chances are too damn high that she will relapse again to justify giving her a second liver when there are people who have conditions totally beyond their control who need any available liver they can get. She can go ahead and die. I feel sorry for her kids, but they have other family who can take care of them.

[bilateralrope]

I agree that she does not deserve to get a liver that could go to someone else. However she is attempting to get a live transplant from her father. So (assuming he is a viable donor) it isn't a choice between her or someone else getting it, the choice is between her getting it or her father keeping his liver intact. Wouldn't that be his choice to make ?

[Napoleon the Clown]

It isn't as simple as being able to simply have her father go under the knife to give his child a third lease on life. If the hospital staff determines there isn't sufficient probability, they'll still be able to refuse to perform the surgery. Having half your liver removed isn't a low-risk procedure, otherwise they wouldn't have a shortage of viable livers. Based off her behavior, she's not going to be able to accept a half a liver, regardless of who it comes from. The hospital isn't going to cut a guy's liver in half for shits and giggles. There has to be a realistic chance of the procedure being a success. And, quite simply, there isn't a reasonable chance of such a procedure resulting in a noteworthy increase in life expectancy.

She's basically fucked due to her own poor choices. The odds of the hospital being willing to perform surgery on her at all are on the low end of things. Even worse for transplants.

[tim31]

2. Issues with surgery? I love this generic attack, blaming the doctors who actually helped her in the first place. Could they be any more vague? Which issues with surgery do you blame for transplant failure? Its like they know a lot of conservative Western Australians won't take this well especially with the drug abuser tag, so they try and blame the doctors.

It is a sad fact of life that people will so often bite the hand that performed life-saving surgery on them. I hardly need to tell you that this is why indemnity insurance is through the ceiling and heading for space. What other small businesses have to advance up to six figures a year as hush money against clients?

[Broomstick]

I thought that opt out programs will resolve the problem with a lack of organs?

No way.

You can't use just any liver, the person has to experience brain death without major organ damage. You also can't have any infectious illness or cancer. All of that rules out most deaths. Organ donations usually come from healthy young people dying in an accident. Even if we managed to harvest every possible suitable organ for donation it would still not be enough to go around. It would not be enough by a large margin.

[PainRack]

so, what is the criteria

[CaptainChewbacca]

so, what is the criteria

For what? For donating organs, or receiving them? Right now this woman's body is so fucked up with drugs and chemicals that even a liver from her father isn't a guarantee. They may be reluctant to do the surgery especially if chance of rejection is above 50%. A father may love a child enough to give them the gift of life, but if it will do serious harm to him for little chance of success the hospital may refuse to do it.

[SirNitram]

Drug addicts don't deserve organs. IF they managed to quit and stay clean, sure. I'm good with forgiveness, real forgiveness. But if not.. GIMME THEIR GODDAMN LIVER!

[Broomstick]

The point being that something as precious as a donated liver needs to go where it will do the most good. That means to the person most likely to survive long term.

It doesn't just stop with the transplant - living as an organ recipient means a 24/7 commitment to maintain your health. Someone who has been clean and sober for an extended period has the self-discipline to do this. An active addict does not. Personally, I don't view "six months clean" as an acceptable test. More like "two years clean". Minimum. Unfortunately, most addicts in acute liver failure don't have that much time in which to prove themselves worthy.

I'm sorry this woman is going to die, but she is. I hope her father can be persuaded against donating part of his liver because, frankly, I doubt it will do any good. A live liver donation means the recipient receives only a partial liver, and it must be guarded more than an intact liver until it grows to full size. Under other circumstances the risk may be justified, but the fact is, a live liver donor takes a hit on his own liver function and there is a real risk of debility or even death.

I understand it is hard to accept death is inevitable. I have been in that place, when we decided to send my mother to hospice and had to finally admit that she really was going to die. I understand the impulse towards denial but at some point you have to deal with reality.

[PainRack]

so, what is the criteria

For what? For donating organs, or receiving them? Right now this woman's body is so fucked up with drugs and chemicals that even a liver from her father isn't a guarantee. They may be reluctant to do the surgery especially if chance of rejection is above 50%. A father may love a child enough to give them the gift of life, but if it will do serious harm to him for little chance of success the hospital may refuse to do it.

Sorry, should had been more explicit. What is the criteria for receiving an organ transplant? Anyone here can fill me in?

[MKSheppard]

Fuck her. She had her chance, and ruined the first liver transplant. Let her die.

Fucking useless druggies.

[PainRack]

I'm sorry this woman is going to die, but she is. I hope her father can be persuaded against donating part of his liver because, frankly, I doubt it will do any good. A live liver donation means the recipient receives only a partial liver, and it must be guarded more than an intact liver until it grows to full size. Under other circumstances the risk may be justified, but the fact is, a live liver donor takes a hit on his own liver function and there is a real risk of debility or even death.

Won't that depend on the donor liver function? After all, the liver has approximately 90% reserve capacity that can be called upon.

[ArmorPierce]

I am sympathetic for her and her family that she is dying at such a young age but organs are of limited supply, she already messed up on her first liver transplant there's plenty of other people more deserving than her for a new liver. She already had a second chance and blew it, it's likely that she'll blow her father's liver too.

[KlavoHunter]

If only we spent more on drug rehabilitation than imprisoning people, maybe this woman would not have needed a liver transplant at all.

[Tanasinn]

If only she hadn't abused drugs, maybe this woman would not have needed a liver transplant at all.