Transplant for Alcohol-associated Liver Disease
Current Policy
U.S. Options
Liver transplant assessment policy has changed significantly at several Canadian and U.S. centres since 2017. All Canadian centres, except Nova Scotia, and several U.S. centres, will tell you they no longer use the 6-month wait.
​
This is NOT necessarily good news. Only patients who did not know their drinking is causing liver failure qualify for further assessment for transplant.
​
Instead, centres assess based on past alcohol use and treatment. If the patient was told to stop drinking and did not, or has been to rehab and returned to drinking, they are almost always rejected for transplant.
​
Patients with chronic liver disease. are rejected under these conditions.
​
Many U.S. centres have continued to impose the 6-month wait. Others have implemented a more forgiving assessment process that looks at drinking history and attempts to recover from alcohol use disorder. They use what is called the "Mathurin Criteria",
If the patient fails the assessment process, they may face a 3- or 6-month wait.
​
The 6-month wait is no longer used in most of Canada. As far as we know, only patients in the Maritimes were still being made to wait.
Several centres in the U.S. are more progressive in their assessment process. These are our best recommendations:
​​
-
University of Chicago
-
University of Maryland
-
Ochsner Health, Louisiana
-
Texas Methodist, Houston
-
University of Southern California, Keck
​
We don't suggest wasting critical time going to any other centre when there is a strong possibility the patient will face rejection a second time.
​
Some larger centres, such as Johns Hopkins, Cleveland Clinic and Mayo Clinic, all assess patients as described in the Current Policy section to the left.
​
Please feel free to contact us if you have any questions.
​
.
​
Ontario
Patients who have been denied a liver transplant in North America can seek treatment at international centres if they have their own living donor.
The following centres were recommended by the world's top liver transplant surgeon:
-
Medanta The Medicity, Gurgaon, India
-
Dr. Rela Institute and Medical Center, Chennai, India
-
International Liver Center & Acibadem Health Care Group, Istanbul, Turkeyin Chennai, India
Canada
All Canadian provinces, except Nova Scotia, have ended the 6-month wait. Continuous legal initiatives and media coverage have helped move the needle. BUT, in place of the Wait, centres eliminate patients who were told to stop drinking and didn't. So, anyone with chronic liver disease is automatically excluded.
Our fight continues.