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Incarceration, marijuana use and suicide attempts may hinder liver transplant eligibility
Date:4/4/2013

Results from an anonymous survey of U.S. transplant providers report that incarceration, marijuana use, and psychiatric diagnoses, particularly suicide attempts, may lower patients' eligibility for liver transplantation. The study published in the April issue of Liver Transplantation, a journal of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, also found that most providers would not offer transplants to patients with advanced age, those severely obese, or with lifetime imprisonment.

"For patients with end-stage liver disease, transplantation is the only treatment option to extend life," explains lead investigator Dr. Josh Levitsky from Northwestern University Feinberg School of Medicine in Chicago, Ill. "With donated livers in such short supply, selecting candidates becomes an ethical exercise for transplant specialists who must balance equal access to transplantation with graft and patient survival."

Currently, the model for end-stage liver disease (MELD) is used to measure the severity of liver disease. The MELD score provides transplant providers with standardized criteria to allocate donated livers. However, the authors point out that subjective assessment of the candidates' medical and psychosocial characteristics could influence the providers' selection process. Medical evidence shows that controversial characteristics such as alcohol abuse, HIV status, obesity, or advanced age may impact allocation, leading to an inequity among patients being waitlisted.

To further understand the ethics involved in selecting transplant candidates, Dr. Levitsky and colleagues sent an online survey to hepatologists, surgeons, psychiatrists and social workers at 102 liver transplant centers across the U.S. Responses were received from 251 providers who answered questions regarding their opinions of characteristics that could prevent patients from receiving a liver transplant
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Contact: Dawn Peters
sciencenewsroom@wiley.com
781-388-8408
Wiley
Source:Eurekalert

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