Alcohol is known to be the leading cause of chronic liver disease around the world, and up to half of all deaths related to end-state liver disease. A liver transplant is the only known cure for late-stage liver disease which includes alcoholic hepatitis and cirrhosis. The use of healthy livers for alcoholic-induced liver disease is a controversial and contentious issue that causes many moral and ethical debates around the world.
International guidelines in most countries stipulate that a person who has alcoholism must abstain from drinking for at least six months before being eligible for a transplant. For those who have severe cirrhosis or other liver damage, there is very little chance of surviving six months from being diagnosed as requiring a transplant. Of those who do receive a transplant, the prognosis is very good. Although it should be noted that often the patients who do receive a transplant have excellent social support, no known psychological diseases and it is the first diagnosis of alcoholic liver disease. For many people who have alcoholism, they do not have the same levels of support, have poor mental health, have many secondary health problems and may have long been diagnosed with alcoholic liver disease.
Some medical professionals, organ donors, communities and individuals believe that an alcoholic person is not deserving of a liver transplant. They’re of the opinion that the alcoholic caused the disease and should not be entitled to a healthy liver. Others believe that alcoholism is a lifestyle-disease, one that a person chooses to develop. They believe that the person should reap the repercussions, whatever they are. Some are of the opinion that an alcoholic person has made the choice to consume alcohol and they can decide when to stop drinking. This is a very simplistic view of a situation that is complex, varied and painful. In addition to these opinions, there is the reality that there are increasing demands worldwide for organ donation and implants, meaning that even those who are considered more deserving have trouble finding an appropriate organ. There is also a significant risk of relapse for alcoholics. This means that, even with a healthy liver, the alcoholic may cause serious damage to their body in the future.
Alcoholic Liver Disease
Alcoholism is a recognized disease that is chronic and progressive. The disease is caused by altered brain structure, environmental and genetic factors and can be treated through a range of medical and psychological interventions. Alcoholism is known to cause many serious secondary health problems including brain damage, liver disease, psychiatric conditions and organ damage. Chronic alcoholism that causes major liver damage can cause a person to develop cancer of the liver and cirrhosis which can only be treated with an organ transplant.
Advocates for those who suffer from alcoholism state that the disease of alcoholism is not something that is controllable or avoidable for some. As with other diseases like diabetes or heart disease, there are known treatments, known risk factors and in some cases a transplant is the only way to resolve the issue. For a person who is at risk of a heart attack or other congenital heart failure, there are particular lifestyle choices that need to be made to reduce the risks, such as eating a healthy diet, exercising and avoiding alcohol and high fat, high cholesterol foods. This is the same for an alcoholic who needs to take steps to avoid triggers, avoid alcohol and make healthy life choices. If a person is committed to their health and willing to make significant changes in the future, they deserve the chance to have a transplant, no matter what their disease.
Liver Damage from Alcohol
Fatty liver is a condition considered to be the first stage of alcoholic liver disease. It can be temporary and resolved if significant changes are made to reverse the damage, which includes reducing the amount of alcohol consumed and abstaining from drinking. It is estimated that up to 90 percent of heavy drinkers will develop the condition at some stage of their alcoholism. Fatty liver is the abnormal retention of lipids within liver cells, known as steatosis. Steatosis occurs because a person has more alcohol in their body than can be processed. The body then retains the excess lipids in the liver and the liver tissue becomes damaged, enlarged and may jaundice.
Left unresolved, fatty liver disease will develop into alcoholic hepatitis. This condition is the inflammation of the liver which can lead to serious tissue damage, including cirrhosis. Hepatitis is known to cause many liver-function problems which include cholesterol and protein metabolizing, processing of fats and sugars, hormone regulating and immune functions. If the liver is severely damaged by alcoholic hepatitis, these functions can be interfered with to the point that the organ is unable to function. It is at this stage that the disease has progressed to cirrhosis.
When the liver is damaged to the point of being unable to repair itself, a person has developed cirrhosis. This is a very serious condition that contributes to the development of liver cancer and is known to cause a person to die. The damage that has been caused to the liver through excessive drinking cannot be reversed. The only known treatment for cirrhosis is an organ replacement.
Not Just a Matter of Stopping Drinking
Like with many other psychological disorders, the public understanding of the causes, contributors and consequences of a mental health disease are relatively unknown. Some people will tell the depressed person to cheer up, the anxious person to calm down and the obsessive compulsive person to just stop. These people also believe that an alcoholic can simply stop drinking alcohol if they really want to. They do not understand how strong an addiction can be, how difficult it is to stop.
Alcoholism is an incredibly difficult condition that has many factors that influence a persons’ treatment. Tolerance, cravings and dependence are serious side effects that can take many years to overcome. Alcoholism can be related to personal trauma, mental health conditions, genetics and environmental factors that can all contribute to a person beginning to drink alcohol and continuing to abuse alcohol. These other factors all need to be resolved and treated along with the physical problems that an alcoholic suffers from.