Should Hepatitis C Patients Who Smoke Marijuana Be Eligible For Liver Transplants?
ScienceDaily (Oct. 22, 2008) — The pain is debilitating. The only option: smoking medical marijuana. That’s the reality for many hepatitis C patients whose road to health includes a liver transplant. Although Canadian transplant centres are more willing than those in the United States, not everyone says yes to liver patients who smoke marijuana, and a University of Alberta researcher says that decision-making process is unacceptable.

Karen Kroeker, along with three other students at various universities, sent out surveys to a number of transplant clinics across the United States and Canada. Results found that the difference between the two countries were obvious in some patient groups: around 60 per cent of Canadian centres would either do the surgery or consider it for a liver transplant patient who smoked marijuana, while 70 per cent of U.S. transplant programs said absolutely not. Kroeker also found that patients in both countries, who have no social support—meaning they have no family, friends or a social worker—aren’t likely to receive the organ they need.

The problem Kroeker has with these results: the lack of literature to support the surgeons’ decision. As a result of her findings, which will be published in the November issue of Liver International, Kroeker says physicians need to determine eligibility criteria for liver-transplant patients that pertains directly to the likelihood of a patient rejecting the organ and is based only on empirical medical evidence.

When a patient is being reviewed for eligibility, whether they smoke marijuana shouldn’t be a factor, she says. “If we have evidence to say the patients don’t do well, then I think that’s a reason to exclude people,” Kroeker said.

She cites alcohol use as an example. When transplants first began to be performed, those who drank alcohol weren’t eligible for a new liver. Kroeker’s study found, however, that surgeons conducted studies on the topic of abstinence and liver health and, as a result of that research, transplant rules changed. If the patient has been sober for six months, 94 per cent of the clinics in North America will now consider transplantation.

Medical marijuana user dies without transplant | KOMO-TV – Seattle, Washington | News
SEATTLE (AP) – A musician who was denied a liver transplant because he used marijuana with medical approval under Washington state law to ease the symptoms of advanced hepatitis C died Thursday.

The death of Timothy Garon, 56, at Bailey-Boushay House, an intensive care nursing center was confirmed to The Associated Press by his lawyer, Douglas Hiatt, and Alisha Mark, a spokeswoman for Virginia Mason Medical Center, which operates Bailey-Boushay.

Dr. Brad Roter, the physician who authorized Garon to smoke pot to alleviate for nausea and abdominal pain and to stimulate his appetite, said he did not know it would be such a hurdle if Garon were to need a transplant.

The case has highlighted a new ethical consideration for those allocating organs for transplant, especially in the dozen states that have medical marijuana laws: When dying patients need a transplant, should it be held against them if they’ve used pot with a doctor’s blessing?

Garon died a week after his doctor told him a University of Washington Medical Center committee had again denied him a spot on the liver transplant list because of his use of marijuana, although it was authorized under Washington state law.

“He said I’m going to die with such conviction,” Garon told an AP reporter at the time. “I’m not angry, I’m not mad, I’m just confused.”

Garon believes he contracted hepatitis C by sharing needles with “speed freaks” as a teenager. In recent years, he said, pot has been the only drug he’s used. In December, he was arrested for growing marijuana.

He had been in the hospice for two months and previously was rejected for a transplant at Swedish Medical Center for the same reason he later got from the university hospital.

Swedish said he would be considered if he avoided pot for six months and the university hospital offered to reconsider if he enrolled in a 60-day drug treatment program, but doctors said his liver disease was too advanced for him to last that long. The university hospital committee agreed to reconsider anyway, then denied him again.