Friday, December 5, 2008

Is Half a Liver Better than None?

Apparently not. Crappy, low-grade livers may even be more dangerous than not getting a liver at all, when it comes to the organ transplant waiting list. Still, would you be willing to play god, deciding who will live and who will die?

The University of Michigan has launched a scathing attack on the status quo for liver allocations. At least, it's as scathing as you'd expect a scientific document to be. Under the current system, the Model for End-Stage Liver Disease (MELD), the sickest patients get the best quality livers the fastest. That sounds good on the face of it, but it turns out to have had grave and inintended consequences.

Since the sickest patients are getting the high-quality livers first, that means that other transplant patients are getting lower quality, high-risk livers. According to the study, some of the patients that have a low pre-transplant risk of death end up getting harmed by receiving a transplanted liver.

Just like the issues involved in experimenting on pregnant women, there are some tough ethical questions raised. Should the risky livers go to the patients with the lowest odds of survival, since they probably won't be able to use it to the fullest anyway? Or should the transplant recipients in good shape be given the low-quality organs because they have a better chance of pulling through afterwards?

It's a call I'm glad I don't have to make, but it's also a strong argument for temperance.

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1 comment:

Atif said...

This is a very important ethical issue that you have brought to light.

In our hospital, there's a waiting list and we strictly follow it unless there's an emergency.

The header image is adapted from a photo taken by Bill McChesney and used under a creative commons license.
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