Wow! wow! I am stunned a liver doctor actually told you those conditions make your SIL NOT eligible for a transplant. Is she at Ohio Medical Center? This is bizarre, or something got misunderstood, perhaps? If she gets her sobriety requirement, and has a support system in place, which she now does with her siblings, she should be ok to be evaluated. Nothing else there is that big of a deal, or unusual with pre-transplant patients.
From Ohio's site:
"Liver transplantation is a critical and long-standing part of Ohio State's Comprehensive Transplant Center (CTC) program.
Patient education, both before and after the transplant procedure, is a hallmark of our program. We also provide access to resources and support our patients and their families need to make a successful recovery.
Liver Transplant Referral
Referring physicians, insurance case managers and other transplant centers can make a referral for a patient to be evaluated for transplantation appropriateness at Ohio State’s Medical Center. Learn more about other steps in the referral process.
Who Can Be a Candidate
Many diseases and conditions may cause liver damage and/or failure. For example, hepatitis B and C viruses, alcohol, autoimmune liver diseases and hereditary liver diseases may destroy healthy liver cells and result in cirrhosis (scarring of the liver). When medical treatment is not effective for keeping a liver functioning, a transplant may be the only treatment. Because of advances in anti-rejection drug management, an increased ability to detect rejection early and refinements in surgical techniques, liver transplantation is a realistic option for many eligible candidates.
Why Candidates Can Be Ruled Out
In the past, age was a major factor in transplantation eligibility. Today, however, patients range from six-month-old infants to 70-year-old adults. Overall health status is what is most considered. Screenings before transplant ensure that you are in good medical and psychological health and that you have the motivation and support to comply with treatment plans. All patients must meet the chemical dependency requirements of the State of Ohio Solid Organ Transplant Consortium. People who have cancer in other areas of the body; serious heart, lung or nerve disease, active drug or illegal drug abuse or active serious infection may be ruled out as transplant candidates" END.
Here is a link to their liver transplant info:
medicalcenter.osu.edu/patientcare/healthcare_services/transplant/Pages/index.aspx Her "mental status" is up to the psych at the transplant eval, not the hospitalist. Also, she is not sick enough yet, to be transplanted, but she may be close. Normally, the lowest end at transplant is MELD 22, but some places do not even list folks until MELD 20 because they transplant in the MELD30-40 range. Do you know what MELD Ohio transplant's at? You can call the pre-transplant coordinator.
Regional hospitals are not that great at liver patient care. They may stabilize her and then transport her each time she comes in. Many places are not equipped to handle complicated liver patients. If she is not on Xifaxan, that medication can help control HE.
She does need sobriety documentation and a good supportive family to get her to transplant. Perhaps go to
open meeting or two together until she is comfortable with AA. No alcoholic wants to go to AA. Ohio may have another option, besides AA. Our Ziff did not do AA, did some other counselor. Some have various rehab classes, or sobriety classes (lostson's Dad). My husband is not alcoholic, so he did not need this requirement. Every center has their own needs, but it is normally 6 mos. But talking to the transplant team will give your these answers.
Since Hep C is now a curable virus, with a relatively easy treatment of 12 weeks. She can treat before or after a transplant. My husband did it with the old drugs, and now has been SVR for a couple of years. But trust me, Hep C does not preclude people from transplant. Nor does cirrhosis, HE, mental clarity issues. And Hep C is a major cause of cirrhosis and transplantation.
This is her life we are talking about
. I do hope she can mend her life, her family and go on to live a long time. There is always hope where there is life. Be encouraged. Unless that doctor was a shrink doing a transplant eval, they can not determine she is not eligible for the reason's they told you.
How it went for us with my husband having HE during eval(and many do).The day we went for my husbands 4 day eval, he had full blown HE from fasting and whatever! ....Anyway, he could not answer questions during this time, told them his wife knew the answers and told them to go get me. Normally, no one is in the psych eval, just the patient. But he was THAT mentally challenged from TIPS induced HE, and they had me answer the questions for him. And he made the list just fine. (That was 1.5 years ago...and we continue to be on the wait list....and he is stable, but sick and in bed much of each day. It stinks, but he is fighting and so am I.
She is a young woman and it would be a shame she does not have every opportunity to live. She needs hope and not to let her past define her. You are such a kind person to do all you do. Know that.
Everyone transplanted has her symptoms and more. Like strokes, heart, diabetes problems, and kidney's crapping out...and on dialysis. Does your SIL have a social worker of some sort to advocate for her welfare? Hang in there. It is not easy. Big Hugs