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November 16, 2011
Page 9
Study Stirs Debate over Liver Transplants
Gravely ill alcoholics
shouldn’t have to wait,
doctors say
(AP) — Some gravely ill alcoholics who need a
liver transplant shouldn't have to prove they can
stay sober for six months to get one, doctors say in
a study that could intensify the debate over whether
those who destroy their organs by drinking deserve
new ones.
In the small French study, the vast majority of the
patients who got a liver without the wait stopped
drinking after their surgery and were sober years
later. The study involved patients who were suffer
ing from alcohol-related hepatitis so severe that
they were unlikely to survive a six-month delay.
The findings, reported the New England Journal
ot Medicine, could boost demand for livers, already
in scarce supply, and reopen a bitter dispute over
whether alcoholics should even get transplants.
The controversy peaked in the 1990s when ce
lebrities with drinking problems — Larry Hagman,
David Crosby and Mickey Mantle — got liver
transplants. More recently, British soccer star
George Best received a new liver in 2002, started
drinking again and died three years later.
Alcohol can cause lethal, liver-destroying dis
eases such as cirrhosis and hepatitis. Nearly one in
five liver transplants in the U.S. go to current or
former heavy drinkers. Transplant hospitals com
monly require patients waiting fora new liver to give
up drinking for six months as a way of assuring
Baseball Hall of Famer Mickey Mantle after a liver
transplant in 1995.
doctors they are serious about staying sober after
the operation.
Drinkers severely ill with hepatitis account for a
very small share of patients needing transplants.
The French study suggests that dropping the six-
month rule for these patients would increase de
mand for livers by only about 3 percent.
The study's lead author, Dr. Philippe Mathurin of
Huriez Hospital in Lille, France, said a strict appli
cation of the six-month rule may be unfair to such
patients. He said they are just as deserving as other
liver patients, many of whom have diseases caused
by poor lifestyle choices such as drug use or
obesity.
Mathurin said he favors keeping the rule for
other alcoholics with liver disease, noting that some
can recover liver function simply by staying sober.
Dr. Robert S. Brown Jr., transplant director of
New York-Presbyterian Hospital/Columbia Uni
versity Medical Center, agreed it is time to rethink
the six-month rule. "The challenge of this paper is
to come up with better ways, both to treat alcohol
ism as a disease and to predict who will succeed
with transplantation," he said.
Mathurin acknowledged that such a change
could put more patients on the waiting list for
organs."It means we have to increase the number
of donors," he said.
Nearly 6,300 liver transplants were performed
last year in the United States, but more than 1,400
Americans died waiting for a new liver, according
to the United Network for Organ Sharing. Adding
more people to the list could mean longer waits and
more deaths among non-drinkers.
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Most Smokers Want to Quit
Despite the known dangers of
smoking, about 20 percent o f
Americans still light up, but almost
70 percent want to quit, a new
government report shows.
"This study is reassuring to us,"
Dr. Tim McAfee, director of the
Office on Smoking and Health at
the U.S. Centers for Disease
Control and Prevention, said
Thursday.
There was a concern that there
was a group of smokers who
would remain smokers and not be
interested in quitting, but what this
study shows is quite the opposite,
McAfee said.
The percentage of smokers
appears to hover around 20 per-
cent as people take up the habit,
he said. "But there has been a
decline in the last five years in the
rate of smoking, and smokers are
actually smoking less," he added.
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