State Medicaid rejects liver transplant for Altoona man with HIV

The Pittsburgh Post-Gazette ^ | Friday, November 21, 2003 | Anita Srikameswaran

[Willie Green]

State Medicaid officials have refused to pay for a liver transplant for an Altoona man because he is infected with HIV, a position the man's attorneys argue is discriminatory and not based on current medical knowledge and practice.

William Jean Gough, 46, meets the medical criteria for the procedure and his survival chances are as good as someone who isn't infected with the AIDS virus, said Hayley Gorenberg, AIDS project director at Lambda Legal in New York, which, along with the AIDS Project of Pennsylvania, is representing Gough in his appeal of the decision.

[dhs12345]

Just curious -- how risky is it for the surgeons? They are dealing with infected blood.

[Bikers4Bush]

There is NO cure for aids. Eventually he will die and what is to keep the Hep C from ravaging the new liver?

Giving him a liver would be like giving someone with an inoperable terminal brain tumor a new organ. Pointless.

[HitmanLV]

To be fair, we are all dying. There is no cure for old age. Eventually we will all die.

Handle this case by case and hope for the best. If he has an unusually short lifespan expected, then it may be wise to pass him up for the organ transplant.

It's not unusual for AIDS patients to live for long periods of time - advances in drugs and treatment make living a more full life more realistic.

[gas_dr]

how risky is it for the surgeons?

Live transplant is an incredibly difficult and bloody procedure. They can bleed more than anyother surgery, and the lines necessary to safely do this proceudre as multiple and complex. This is horrendously risky for both the surgeon and the anesthesiologist.

[anobjectivist]

I thought that as well.

Any doctor certainly can opt out of the operation because of the risk involved.

That probably also increases the cost of the operation a substantial amount as well.

[cinFLA]

There is NO cure for aids. Eventually he will die and what is to keep the Hep C from ravaging the new liver?

The article does not say aids - it say HIV.

[discostu]

Your own backyard

[Bikers4Bush]

You're right we are all dying, but we all haven't fast tracked ourselves in that process by engaging in risky behaviors.

He either caught AIDS and Hep C by sharing needles or through his sexual practices. Had he caught it through a blood transfusion you can bet they'd have mentioned it. Either way neither of those diseases is curable and both are ultimately fatal.

There's an organ shortage as it is in this country, there's no point in putting the few that are available into people with terminable diseases that replacing an organ won't fix.

[KantianBurke]

bump to post #9

[Bikers4Bush]

HIV and Aids are one and the same, one stems from the other.

To say that they aren't is ignoring the facts and perpetuating a lie.

Cancer is cancer, they could have done the same thing the aids activists did and called what happens to the body as a result "cancer related illnesses" but it still wouldn't change the fact that the cancer killed you.
You get HIV and the results of the HIV is the destruction of the immune system and a subsequent breakdown. Calling the process by which the HIV virus kills the body by another name doesn't change the fact that contracting the HIV virus caused the breakdown.

[dhs12345]

It boils down to who is the most likely to benefit (quality of life, etc.) from the transplant.

It would be a tough decision; AIDS/HIV or not.

How often do Hepatitis patients get liver transplants? Are they low priority?

[dhs12345]

Can't blame the doctor for not wanting to take the risk.

[HitmanLV]

I basically agree with you, but what I'm saying its case-by-case.

Big drinkers ruin their livers - they are fasttracked to death because of their behavior. Yet, they get organs just like anyone else would/

It's case by case. I'm with you though - the whole organ industry royally sucks, but what can we do? Until we can develop machines that can be used for organs, or be able to clone organ parts, it's a sucky system out there.

[Bikers4Bush]

Actually that's not comletely true. Alcoholics can be and are denied transplants if they continue to drink or refuse to enter rehab programs.

Same thing with smokers and lung transplants. They can be and most of the time are refused the transplant if they won't stop smoking.

[Bikers4Bush]

And I agree that the system in place isn't ideal but at this point it's all we've got.

[HitmanLV]

I know - what I am saying it's case by case. It's entirely possible someone who damaged their organ (yet turned over a new leaf) could be given a new organ.

[leadpencil1]

He could try to find a living donor. Then there would be no complication with the "waiting list".

[bigfootbob]

"How often do Hepatitis patients get liver transplants? Are they low priority?"

#1 cause of liver transplants world-wide.

[Bikers4Bush]

Very true. There are cases like that.

I just shudder to think of this guy getting a liver that could have gone into some kid instead and the kid dying waiting for another one while the diseases that this guy has contracted continue to ravage his body and the new organ.

In a case like this that guy should be last on the list, if everyone else that could be offered the organ refuses it then he gets his shot.