Liver Transplants For Alcoholics Abstract

LiverTransplants For Alcoholics


Allover the years, alcohol abuse and addiction has been on the rise withmore and more people engaging themselves and becoming victims of suchunhealthy practice. Excessive and prolonged alcohol consumption hasbeen the leading cause of liver damage and other diseases such asalcohol cirrhosis, alcohol hepatitis, and alcoholic fatty liverdisease. Various statistics have also shown that there is a very highdemand for liver transplants by patients both the alcoholics and thenon-alcoholics. However, a liver transplant for the alcoholics hasbeen an integral point of discussion eliciting mixed reactions fromscholars, individuals and the general public with each grouppresenting various arguments to justify their claims. A lot of peopleview alcoholism as a self-inflicted practice and hence the alcoholicpatients should be denied a liver transplant.The study will thereforepredominantly focus on justifying liver transplantation for thealcoholics as much as the counterclaims raised might be true to someextent.

Tableof Contents

Introduction 4

Counter argument 4


Plan 9

Conclusion 11

References 14

Aliver transplant typically refers to a surgical procedure whichentails the removal of a damaged or diseased liver and replacing itwith a healthy one from a donor. The entire operation is usuallyperformed by specialized surgeons together with anesthesiologists aswell as the nurses whose role is to offer the necessary support. Asubstantial number of studies conducted by various scholars haveestablished that alcohol addiction and its excessive usage is verydetrimental to the victims since it is the leading cause of chronicliver disease. The liver is the chief organ that is responsible forfunctions such as metabolism and the removal of harmful substancesfrom the human body. This implies that alcohol consumption has gottoxic effects on the liver. A habit that has resulted to asubstantial increase in the number of people losing their lives dueto alcohol not only in the United States but also in many othercountries across the globe. I therefore fully support the idea thatthe alcoholics should be allowed to go through liver transplantationsince it is the only way in which they can have a second chance inlife.


Despitethe fact that liver transplants is very fundamental in giving alcoholaddicts another opportunity to continue living, the process hashowever raised eyebrows with a number of arguments brought outsuggesting that heavy and chronic alcohol drinkers should be deniedliver transplants (Debatewiseorg n.d).Variousreasons have been presented to dismiss the argument that alcoholaddicts should be allowed to go through surgery for livertransplantation(Vibhaet al 2010).They have been blamed for their own actions thusdisqualifying them from bringing up unnecessary competition for thesame organs required by other sick patients who are deemed to beblameless. The model has been further supported by the claim that,since most of the countries across the globe distribute livers fortransplantation on a queue-based system, it is prudent for them notto include the alcoholics who need a liver transplant in this queues.In addition, a liver transplant for the alcoholics has been refutedon the basis of life expectancy (Busuttil&amp Klintmalm, 2014).Alcoholaddicts are assumed to have a shorter life span compared toteetotalers.

Further,excessive alcohol consumption often weakens the immune systems of thevictims thus subjecting them to more complications or other healthrelated problems. It is also argued that conducting liver transplantto the alcohol addicts doesn’t give any assurance as far asabstinence by the recipients is concerned. Such medical criteria isused to justify the claim that alcohol addicts and heavy drinkersshould be denied liver transplants and priority given to rest of thepopulation. The teetotalers are perceived to have a longer lifeexpectancy apart from them being less vulnerable to healthcomplications (Debatewiseorg n.d).Moreover,there are worrying concerns raised by various medical centers inwhich they claim liver transplants for the alcoholics will adverselyaffect the publicity process thus jeopardizing transplant surgery ingeneral. This will negatively hamper the initiative and noble idea ofpersuading more people to donate the organs in an effort of trying tosave more lives as possible subsequently intensifying the severeshortage that is already being experienced in many parts of the world(Busuttil&amp Klintmalm, 2014).

Asmuch as the counter arguments raised against liver transplant for thealcoholics may be true, the process should be done as it is the onlyway that is known to address severe cirrhosis or any complicationsrelated to the damage of the liver thus giving hope to the alcoholicsand increased chances for them to survive (Debatewiseorg n.d).In refuting the counterclaims, the practice of denying heavy drinkersliver transplants simply because of their condition is inhuman andunfair. Instead of subjecting them to a death sentence, medicalpractitioners, and professionals should focus on assessing the levelof necessity and urgency of victims hence able to determine theirmedical needs (Clavien&amp Trotter, 2012).After the evaluation, the patients will then be placed on thewaitlist. This will be very helpful to the surgeons in determiningthe criteria to use so that all patients are given the attention theydeserve. For the alcohol addicts, an absolute abstinence for asix-month period should be embraced before conducting the surgery andliver transplant. However, the people confirmed to have little or nochances of survival irrespective of the reasons for their liverdisease, they should not be given liver transplants. Patients shouldnot, therefore, be denied liver transplant because of their pastalcoholism behavior (Debatewiseorg n.d).The surgeons and anesthesiologists should be optimistic about theirfuture and general life thus give them a chance for the livertransplant.

Inaddition, it is clearly inappropriate holding onto the claim andassumption that all the alcoholics as a group have very little or nochances of success due to their lowered immune system. It isadvisable and sensible for the cases to be investigated at a personallevel to establish if it is their alcohol behavior that is mitigatingtheir likelihood of success or it is due to other health risks. Bydoing so, it will be acceptable for the medical practitioners todiscriminate and deny them liver transplant since the judgment willbe based on established facts rather than an assumption orperception. Again, there is no proven claim that alcoholics arelikely to die earlier when compared to the non-alcoholics. Althoughon average, the alcohol addicts might have a shorter life spancompared to the rest of the population (Debatewiseorg n.d).However, this doesn’t validate the claim of denying a specificalcoholic a liver transplant because of the generalization whichsometimes is not true. In some situations, the alcoholics might behaving a longer life expectancy compared to the non-alcoholics or therest of the population.

Arguably,in a scenario whereby a non-alcoholic has a certain disease, forinstance, cardiac arrest while the alcoholic does not. In such cases,there is no assurance that the non-alcoholic will have a longer lifeexpectancy than the alcoholic. Therefore, it is not in orderdeprioritizing the alcohol addicts and denying them liver transplantsbecause of alcoholism. Unquestionably, based on moral grounds andprinciples, it is only reasonable holding individuals culpable andresponsible for their personal deeds rather than judging them as agroup and prioritizing those who are blameless (Debatewiseorg n.d).The same case ought to be applied in giving the alcoholics a chancefor surgery.

Regardingthe negative publicity and people declining to donate organs forsuccessful transplants for alcohol victims, appropriate measures andmechanisms should be put in place to sensitize and enlighten theentire population on the importance of saving a life. This will playa substantial role in changing their attitude such that they can seethe alcohol addicts as their fellow human beings who deserve a secondchance in life. Training programs should be initiated and implementedfor people to be aware that alcoholism is just like any other diseasewhich requires specialized attention. More importantly, surgeons andother medical practitioners should make good use of the donatedorgans so that more lives can be saved. For instance, a donated livercan be split into two in an effort of trying to address theirshortages (Clavien&amp Trotter, 2012).


Amidstall the controversies and claims presented arguing that alcoholicsshould be denied liver transplantation (Vibhaet al 2010). It is evident that liver transplant is the only way thathas been so far identified and recommended to be effective intreating end-state liver diseases such as alcoholic hepatitis andcirrhosis. Alcoholism is just like any other common disease that caneither be avoided through abstinence or controlled by enlighteningthe addicts on the harmful effects associated with alcoholism. If thecauses are determined and the victims decide to make considerablechanges in their current and future lives, then they really deserve aliver transplant. The surgery is important for the alcohol victimswhose body organs might have been damaged or developed complications.Allowing them to go through the operation renews their hopes andincreases the probability of having another chance in life. Accordingto the federal data released by the Organ Procurement and TransportNetwork, there is an acute shortage in the number of livers donatedsubsequently resulting to more and more people losing their livesbecause the number of recipients is way too high compared to thelivers donated. The data indicates that more than 16000 Americancitizens need a liver transplant with only 6000 organs available on ayearly basis. Also, it is argued that approximately 2000 patients diewhile waiting for the organs to be available (Busuttil&amp Klintmalm, 2014).From the statistics, it is evident that liver transplantationtogether with the availability of the organs is very essential insaving the lives of both the alcoholics and the entire population.

Accordingto the new study by French researches, it is argued that if livertransplantation is carried out early enough, it substantiallyimproves the survival chances of patients experiencing severehepatitis for the first time which does not respond to any medicaltherapy (Mathurin, Moreno, Samuel, Dumortier, Salleron, Durand &ampDharancy, 2011). Further, the National Institute on Alcohol Abuse andAlcoholism identified alcohol hepatitis to be a fatal condition whichresults in the scarring of the liver and a leading cause of deaths inthe United States (In&amp In, 2015).Why should alcoholics be discriminated yet there is a significantnumber of patients with health complications, some of which arehighly attributed to voluntary or intentional unhealthy practices?For instance, the smokers who suffer from chronic lung cancer due totheir harmful smoking habits. Another example is the individuals whodevelop the coronary artery diseases due to their negligence orlittle concern is given to their blood pressure taking foods rich incholesterol as well as avoiding physical exercises and workouts.

Theentire health care systems and professionals should take this intoconsideration and respond to the health needs of a patient ratherthan focusing on behavioral, infectious or genetic factors that causethe medical complications (Clavien&amp Trotter, 2012).It is, therefore, worthwhile giving the alcoholics the specializedcare and treatment just like any other patients who need the livertreatment for various reasons. Alcohol addicts should not be singledout because of their past behavior. All the liver transplantationpatients should receive an equal share of the personnel, money andmedication resources which are relatively scarce (Vibhaet al 2010).


Accordingto the National Institute on Alcohol Abuse and Alcoholism report(2016), approximately 88,000 people die annually in the United Statesas a result of alcohol related complications. The statistics arebecoming a global challenge because of the harmful effects associatedwith alcoholism. Excessive and long-term consumption of alcohol hasbeen established to be the leading cause of liver failure, chronicliver diseases, and even death. Orthotropic Liver Transplantation isthe only cure for such like patients.

Thepurpose of this plan, therefore, is to provide an understanding ofhow the much-needed liver transplants should be conducted to allpatients in a fair and non-discriminatory manner. Apparently, thereis a severe shortage of donor organs such that the Orthotropic LiverTransplantation and Alcoholic Liver Disease patients are given littleor no priority for medication (O`shea, Dasarathy &amp McCullough,2010). The various transplant centers should focus on conductingcareful and comprehensive screening procedures to determine thepatient’s physiological status together with their medicalcondition after which they will be able to select the most suitablecandidates for the process.

Theplan is in line with the Healthy People 2020 goals that seek toimplement a 10-year objective initiative that is dedicated towardsimproving the general health of all the Americans (, 2014).The health of all patients is paramount and should be prioritizedwithout disparities or any form of discrimination. Further, the planadvocates for longer lives with high standards of living, free fromall diseases which can be prevented as well as creating a suitablephysical and social environment that promotes good health for allpeople by cushioning from risks associated with injuries,disabilities or possible deaths. In addition, the plan will alsoadvocate for desirable behaviors and practices across all stages ofan individuals’ life for a much better life and a healthy living.All these goals have a close relationship with the professionalnursing practice which the nurses are obliged to such that theyexecute their responsibilities in a professional manner. This isconsistent with the expected high-quality nursing care and also thecompetence and ethical requirements associated with the profession.

Theprocess of procurement and effective distribution of any donatedorgan to the patients is sometimes faced with various challengesranging from technological, medical, and financial to humanresources. On the financial part, the plan advocates for optimumminimization of the factors that cause unnecessary loss of organs(Busuttil&amp Klintmalm, 2014).People should be encouraged to embrace a healthy lifestyle throughtheir diet and eating habits, also, there is need for them to createtime out of their busy schedules for workouts and physical exercises(Council for Disability Awareness (2015). Besides, proper trainingshould be given to the smokers and alcoholics so that they beinformed about the harmful effects associated with excessive orprolonged smoking and drinking. By doing so, the risks connected toheart diseases, cancer, and liver complications are mitigated. Also,the already donated organs should be used properly (O`shea et al,2010). For instance, a single donation of a liver should be used tosave two lives.

Inaddition, more resources should be invested in the education sectorto train more surgeons and anesthesiologists to address the shortagesexperienced in this particular field. Again, the plan advocates forthe construction of more transplant centers with well-equippedmedical facilities. The centers should embrace high levels oftechnology for better services. Equally important, the facilitiesshould effectively accommodate the higher number of patients apartfrom giving them specialized medical care. It is also important tonote that the process of organ donation has got its legal aspect.There should be a voluntary consent between the donor, medicalpractitioners, and any other relevant parties before the donation orsurgery is effectively conducted (Clavien&amp Trotter, 2012).


Asit has been noted, several reactions and opinions have been presentedpostulating that alcoholics should not be considered for livertransplantation (Sinead2010).Several arguments have been brought out to justify theirclaims. First, liver damage, failure or any other diseases due toalcohol is assumed to be self-inflicted and a voluntary behaviorhence the victims should be disqualified from competing for arelatively scarce resource which other patients need (O`shea et al,2010). Another assumption given to deprioritize alcoholics is thebelief that they are more vulnerable to diseases and other healthcomplications hence their life expectancy is shorter compared to therest of the population.

Also,various medical centers have raised concerns on the few number ofindividuals coming out to save lives by donating the organs whichliver transplantation patients are in dire need for them to survive(Clavien&amp Trotter, 2012).This is because of the negative publicity that’s is created withthe postulation that the donated organs will be used to save thelives of the alcoholics who willingly engage themselves in suchharmful behavior. However, alcohol addicts should be treated fairlyand subjected to the same medication as the rest of the otherpatients. This is because alcoholism is just like any other diseasesuch as obesity or lung cancer that is caused by the unhealthy habitsand practices of the victims. Alcoholics, therefore, shouldn’t besingled out and discriminated when it comes to liver transplantation.Again, the hypothesis that alcoholics have a shorter life expectancyand are more vulnerable to diseases is inappropriate and untrue(O`shea et al, 2010).

Patientssuffering from other illnesses such as cardiac arrest and lung cancermight actually have a shorter life span compared to the alcoholics.Also, there is need to enlighten the general public on the negativeperception they have towards the alcoholics which is hindering themfrom donating organs required to sufficiently meet the needs of therecipients. It is very important for them to realize that alcohol isa disease which can be controlled. The gift of life is critical andeveryone should play a role in protecting and safeguarding it as muchas possible. Medical practitioners, surgeons together withanesthesiologists should use Psychosocial Assessment of Candidacy forTransplantation (PACT) scale as a tool to evaluate and determine thecandidates suitable and qualified for a kidney transplant(Clavien &amp Trotter, 2012).The scale is necessary and crucial in evaluating the recipients’physiological health, social support, lifestyle practices that mayhave contributed to their current condition and also assessing thepatients’ level of understanding as far as liver transplantation isconcerned including the follow-up processes after the transplant hasbeen done (Busuttil&amp Klintmalm, 2014).

&nbspSummingup, liver transplant is an integral process for all patients. It isinappropriate victimizing, discriminating or giving a death sentenceto the alcoholics because of their past behavior. Alcoholism is justlike any other psychological disorder which can be controlled orcured. More and more people should be encouraged to save the lives oftheir fellow human beings. The only scenario where the alcoholicsshould be denied or given a lower priority for liver transplants iswhen a particular group has been confirmed to have a poor orunacceptable transplant prognoses. Apart from that, this studyaffirms that there is no justification for denying alcoholics livertransplants. I fully support liver transplantation to be done to allpatients without any victimization or discrimination. The alcoholicsshould be allowed to undergo surgery for liver transplants since theytoo deserve a second chance in life (Vibhaetal2010).


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