A young Inuk woman from Labrador has become the latest person to battle Ontario's organ donation agency over its policy of rejecting liver transplants for alcoholics who haven't abstained from drinking for six months.
Friends of Delilah Saunders, a 26-year-old advocate for Indigenous rights, have launched a campaign for her inclusion on a transplant waiting list.
"Her liver is kaput and her chances of survival are pretty low without a new liver," Rebecca Moore said Thursday after visiting her friend the night before at the Ottawa Hospital.
The Trillium Gift of Life Network, which allocates organs for transplants in Ontario, says its abstinence policy is used across Canada and the United States.
Dr. Atul Humar, director of transplantation at the University Health Network in Toronto, said one of the reasons for the widely applied policy is that there is research suggesting some alcoholics who receive transplants will resume drinking, causing their new organ to fail.
"If someone continues to drink after their liver transplant, they risk damaging that organ as well. The rationale is that if people can abstain for some time prior to a transplant, they can abstain for some time afterwards," he said in an interview.
Moore said Saunders' family is considering a court injunction.
She says her friend is anxious to take part in a Trillium pilot project, beginning in August, that will waive the abstinence policy for some alcoholics who agree to receive support for dealing with their addiction.
Moore said the abstinence policy is preventing her and others from offering themselves as possible donors, while Saunders remains hooked up to hospital machinery to keep her alive. She was admitted to the hospital on Saturday.
"It's frustrating wanting to be able to go and get tested to see if you're a match to save your best friend's life but being told, 'No, they're not even going to give it a chance,'" said Moore.
Humar said doctors must also consider that if they transplant a living person's liver to another person, there should be a high likelihood of success.
"It's a major operation and we only want to do that if we're sure the transplant will be successful."
The doctor said there is significant shortage of donated livers. As a result, about one third of the people in the program die while awaiting a transplant.
Saunders is the sister of Loretta Saunders, who was murdered three years ago by two people subletting her Halifax apartment.
The Saunders' family recently gave emotionally charged testimony before the National Inquiry into Murder and Missing Women and Girls at Membertou First Nation in Cape Breton.
As for the challenges Saunders faces in getting a transplant, her case is the latest in a series of similar cases in recent years.
Cary Gallant, a 45-year-old alcoholic denied access to the Ontario wait list, had launched a case in the fall challenging the constitutionality of Trillium's rule.
Gallant's goal was to have Trillium agree to assess patients who consume alcohol on a case-by-case basis for possible waivers.
Debra Selkirk, whose husband Mark died from liver disease, had planned a constitutional challenge of the six-month policy when he was refused a transplant.
She said she dropped her two-year fight due Trillium's commitment to start the pilot project and to provide transplants to almost 100 patients with alcohol-related liver disease.
"I think an exception should be made for everybody," she said. "I think they should start transplanting now."
A spokeswoman for Trillium did not respond to a request for an interview on the medical reasons for its policy.
However, Jennifer Long wrote that the agency is "in the midst of finalizing the pilot program."
Humar said there is variation in existing research on what percentage of alcoholics who are provided with transplanted livers will return to drinking.
"In patients transplanted for alcoholic liver disease the (rates of recidivism) is anywhere from 10 to 40 per cent. It varies a lot on the types of patients transplanted, how long they've been abstinent and what kind of addictions support you have on hand for those kinds of patients."
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Michael Tutton, The Canadian Press