“We were told last week that he only had a few weeks to live, maybe a month with a bit of luck,” said his companion, Nathan Allen.
This article was translated from content from CTV News.
Huska, 36, was referred to University Health Network (UHN), the nation’s largest liver transplant center, for a liver transplant. However, his request was rejected.
In documents provided to CTV News, notes show Huska’s application was denied after the UHN alcohol-related liver disease team reviewed her medical information and conducted a psychological examination, noting that their decision was based on “minimal abstinence outside of the hospital.”
Medical notes suggest she began drinking in her late teens and tried – unsuccessfully – to stop. After periods of sobriety, she returned to alcohol, which could increase the risk of continued use after transplantation.
According to Mr. Allen, Ms. Huska enrolled in a drug treatment program early on in her hospital stay in order to stop drinking after she was released from the hospital. Hospital records also indicate she suffers from anxiety.
“She told me it was a wake-up call for her and she wanted to change her life,” Mr Allen said.
UHN’s refusal also prevents it from receiving a liver from a living donor, who would have to have a compatible blood type and meet other medical criteria.
Nathan says he has a compatible blood type and would be her donor if he could.
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Refused
Access to “a life-saving procedure is based on the perception of bad behavior,” said Debra Selkirk, who has campaigned for more compassion for people suffering from liver failure due to alcohol abuse.
Selkirk’s husband Mark was denied a transplant due to his drinking and died of liver failure in 2010.
Selkirk notes that many other chronic illnesses lead to organ failure.
“People are not turned away because they haven’t exercised, because they work too much, because they don’t get enough sleep, or because they didn’t follow their doctor’s recommendations . In the case of Nathan and Amanda, someone was told, ‘You didn’t follow the doctor’s orders, so we’re not going to help you. We’re going to let you die,'” he said. she declared.
Amanda’s story is part of a growing and worrying trend, according to liver specialists. Historically, liver cirrhosis or liver failure was a disease seen in older men who had been drinking alcohol for decades. Today, it affects younger adults and more and more women.
“We are seeing people under the age of 40 with severe alcohol-related liver damage much more often, which is a change from when I trained over a decade ago,” observes Dr. Jennifer Flemming, associate professor of medicine and public health sciences at Queens University.
Data collected by Flemming based on emergency room visits in Ontario showed that 36% of young adults presenting to emergency rooms with liver disease were women. Further analysis showed that these women had a 50% higher risk than men of progressing to liver failure.
People diagnosed with liver failure often need a liver transplant to survive, “and the number of organs available for transplants is very limited,” Flemming adds.
But the chances of getting a liver, whether from a deceased donor or a living donor, are low.
A University Health Network study showed that 86% of people with alcohol-related liver damage who were referred for transplant were rejected. Only 14% of candidates were accepted and only 6% received a liver transplant.
The criteria are strict and involve physical and medical tests as well as psychological evaluations to determine who will benefit the most and for the longest time.
“Unfortunately, as we try to find a solution, we see more and more young people suffering the consequences and not being able to access transplantation,” Ms Flemming said.
Studies show that transplants for alcohol-related liver failure are generally successful. The one-year survival rate is over 94%. However, around one in ten people start drinking again.
A rare and precious resource
With some 600 Canadians waiting for liver transplants for various illnesses, including hepatitis and cancer, deciding who will receive a liver is not easy.
“It’s a precious gift. It’s a limited resource,” explains Dr. Saumya Jayakumar, a liver transplant surgeon in Edmonton.
She was not involved in Amanda’s case, but notes that recipient selection criteria are fairly consistent across Canada’s seven transplant centers. Criteria typically include the patient’s awareness of their addiction, willingness to stop drinking, mental state, and family support after transplantation.
“As you can imagine, making these decisions can cause significant moral distress among team members. So it’s a decision made by the entire team and involves a number of hepatologists, transplant surgeons or social workers,” she told CTV News.
His research shows that length of sobriety before transplant was not a determining factor. In other words, the two patients who abstained from alcohol for a six-month baseline period had similar results to the patients who received a “fast-track” transplant, without waiting.
According to Ms. Jayakumar, it is mental health issues that are the most decisive in deciding whether a transplant is appropriate.
“We can give you a brand new liver, but if we can’t change all the circumstances that led to the liver failing, have we really done ourselves a service?”
Dr. Saumya Jayakumar, liver transplant surgeon in Edmonton
“I would say that all transplant centers in Canada have difficulty accessing mental health funding for patients, as well as mental health practitioners for transplant programs,” she added.
When asked about Amanda Huksa’s case, UHN officials provided a statement to CTV News.
“We are unable to comment on individual cases due to patient privacy, but we can say that there are many eligibility criteria for living donors, only two of which are blood type and will. Recipient criteria are governed jointly by the transplant centers and the Trillium Gift of Life Network,” it was written.
Nathan, meanwhile, claims to have found a hospital in Europe willing to perform a living liver transplant if Amanda defies the odds and survives long enough. He hopes to finance the costs through crowdfunding, which could exceed $300,000.
“I will do everything I can to save his life, as the medical profession should do here.”
– Nathan Allen, spouse of Amanda Huska
Why are women more at risk of alcohol-related liver disease?
Doctors say there are several reasons why women appear to be more at risk of alcohol-related liver disease than men.
Women produce 30% less of an enzyme in the stomach that breaks down alcohol. This means that the effects of alcohol may be more pronounced.
Women also have lower body mass and lower water content. This means that alcohol is found in greater concentrations in women.
Studies also show that women are consuming more alcohol than in the past, with products like fruity soft drinks targeting young women.
When drinking too much alcohol over time, the liver stops processing it and produces highly toxic chemicals that trigger inflammation. This can kill healthy liver cells and permanently damage the liver. The International Agency for Research on Cancer has labeled alcohol a toxic, addictive and carcinogenic substance, linked to cancer and liver disease.
Canada has released new alcohol guidelines in 2023, suggesting no more than one drink per week.
If detected early enough, the disease can be reversed. People can change their behavior and lifestyle by drinking less, which will allow the liver and other vital organs to regenerate and avoid the need for hospitalization or even transplantation when the patient is older. age.
Some health groups are calling for stricter alcohol policies, fearing that expanded sales planned in Ontario this fall could increase alcohol consumption and the risk of liver disease and cancer.
