General Discussion
In reply to the discussion: Sick: LA Hospital Denies Life-Saving Organ Transplant to Medical Pot User (Again) [View all]Ms. Toad
(34,069 posts)Managing care post transplant is very tricky and it is critical for the success of the transplant that the patient be medically compliant. It is well known, at least among populations heading into transplant (and my daughter is a few years away) that you must follow the transplant doctor's rules as part of demonstrating that you have the capability to be medically compliant so that the organ (of which there are not enough to go around) will not be wasted on you because of failure to be medically compliant.
In the second case you cited, there are likely two problems:
1. The transplant rules almost certainly prohibited the use of marijuana (I am not aware of any that permit it)
2. The patient probably didn't inform her transplant doctor of the drugs being authorized by the other physician (which may or may not have made it into the drug use portion of the medical record - if it was easily accessible). It is the patient's responsibility to provide complete and accurate information (or verify what is in the record) to each physician - and because of the drug interactions and the risk of drug interactions that might result in organ rejection, it is especially important that the transplant physician be fully informed of all drugs, prescription or otherwise, which are being taken.
If there are medical reasons for not following the transplant physician's orders, you have to work with him or her to obtain consent to vary from the protocol. This is not impossible. My daughter is on a medication he initially refused to prescribe. We built our case, and he agreed to prescribe it. It is a medication we could have just had another physician prescribe to get around his restriction, but we know (as anyone should heading into a transplant) that doing so would risk being able to obtain a transplant because we were not compliant with her transplant physicians orders (and she is not yet at the point of being listed - but we would never risk that because that non-compliant record might put her ability to live in jeopardy).
It may sound harsh, but there are currently about 17,000 people waiting for livers and only around 6000 a year available. Transplant physicians have a limited ability to judge who will best be able to care for the liver. They must make life and death decisions as to who is eligible to receive them, so they use all the tools available to assess the intangible pieces like ability to care for the liver post transplant. When there aren't enough to go around, giving a liver to someone who is unable or unwilling to be medically compliant is not a good decision.