Following a widow’s legal challenge, Ontario will temporarily lift a policy requiring alcoholics to be sober for six months before they can be considered for a liver transplant.
Debra Selkirk, whose husband Mark died in 2010 after being refused a liver transplant, filed the constitutional challenge against the six-months-sober rule in 2015. She argued that the transplant policy discriminates against people who are struggling with alcoholism and violates Canada’s Charter of Rights and Freedoms.
Ontario’s organ and tissue donation agency, the Trillium Gift of Life Network, has now agreed to run a pilot program that will make patients with alcoholic liver disease eligible for a transplant, even if they haven’t ceased drinking for six months, Selkirk said. She said the program is a direct result of her legal challenge.
“It was devastating for me to lose my husband. Once I realized what happened to him, I felt it was time to create some change in the system,” Selkirk told CTV News Channel.
The Trillium Gift of Life Network has not yet formally announced the program or released details to the public.
But in an email to CTVNews.ca, a Trillium spokesperson confirmed that the agency is developing a three-year pilot program “to determine if there an evidence-based basis to change the criteria” for placing patients on the liver transplant list.
“I’m really pleased about the outcome. I think it will offer fair opportunity for people,” she told CTVNews.ca in a telephone interview from Toronto on Tuesday.
The agency is “in the midst of finalizing” the program and securing the necessary funding, spokesperson Jennifer Long said in the statement.
“In the interim, it is important for all Ontarians to know that the listing criteria for liver transplants remain unchanged,” she added.
Long said that Trillium’s current research on liver transplants “points to a six month abstinence from alcohol for alcoholic liver disease patients as the most commonly used protocol across Canada, the U.S. and other international jurisdictions.”
Selkirk said she has met with Trillium representatives and has seen some of the documents about the program.
She said the pilot project will offer a more “holistic” approach to transplants for alcoholic liver disease patients. Each patient approved for a liver transplant will be assigned a team of health-care professionals, including a psychiatrist and social worker, Selkirk said.
While she’s pleased with that approach, Selkirk said research shows that most alcoholic liver disease patients do well on their own after a transplant, and very few return to drinking.
She has previously cited a 2008 research paper that found only about six per cent of former alcoholics and four per cent of former illicit drug users relapse following an organ transplant.
Other studies have reached similar conclusions and a paper published in 2006 described the “rigid” six-month-sober rule as “ethically problematic.”
In Selkirk’s case, she even offered to give her husband a piece of her own liver, but doctors refused that option as well. She and others have argued that there is no scientific basis for Trillium’s six-month wait policy.
According to a 2015 report on the state of public health in Canada, the number of deaths from alcoholic liver disease increased from 1,104 in 2000 to 1,535 in 2011.
Selkirk argues that the time it will take Trillium to get its pilot program up and running could mean life or death for those waiting for a transplant. She said the program is not expected to launch until next August, and she plans to file a court injunction against the six-month sobriety rule in the interim.
Since her husband’s death, Selkirk said she has received many calls and emails from patients in desperate need of organ transplants, and their families.
“They are heartbreaking,” she said. “There was a mom who made it to five months and three weeks in April, and because of that last week that she had to wait, she died.”