WTF? Do they take cigarette smokers off of the roles? Pot is on of most most benign substances around, they have no right to bump her off the list.

Do they accept donor parts from donors who smoked pot? They hand this woman a death sentence for taking something that grows as a weed all over the US?

It seems she was taking it to reduce the symptoms of her terrible disease. Would they do this to a 1%er? Dick Cheny got a new heart, how many drugs was he on?

So, the compassionate grand old party are accessories for this person's death? What if a Bush needed the kidney, I'm sure they'd stick to the rules...NOT!

to Mickey Mantle or David Cosby.

You don't get a kidney transplant of your a drug or alcohol user/abuser. If you want the kidney, follow the rules.

and about as full as lunas atmosphere.

Of course I'd love for her to have gotten the transplant; but there's a long list of people that need them, and if she isn't willing to follow the rules (Mickey Mantle anyone?), then she shouldn't get one.

A woman is prescribed medical marijuana by her physician in a state where that is legal. She is then denied a medical procedure by a hospital in that same state over her prescribed use of that legal substance, having never been informed prior to that time that she would be denied the operation due to her use of the legally prescribed marijuana. Some rules.

Typically a substance abuse contract is part of getting on the list, yes? How explicit was the document she signed, I wonder?

you can't prove "abuse" by a producing a script.

Debating the merits of medical marijuana is one thing. I can guarantee you that if you're on the list for a kidney transplant you have to agree to, and likely prove, that you are drug and alcohol free for something like a year. If she told her doctors that she was using and they never told her to stop, that's another story but that wasn't mentioned.

Just because marijuana is legal in a state, like alcohol is, does not mean you can ignore the medical requirements your doctor/hospital has instructed you to follow. These rules are in place so chronic alcoholics can't burn through their kidneys, then get a reset on a new one and go back to the party. I have no problem with this; precious organs should go to people who care enough to follow the rules.

They'll probably say something like the doctor doesn't have the authority to override their standards. Regardless, if you're waiting for a transplant and they say don't use marijuana, medical or not, you're better off not. Complain all you want, but those are the rules in place and you have to deal with them.

It's really absurd that a transplant program can't see past the word marijuana. If the patient's appetite improves through the medically supervised use of it then presumably the patient is not as weak as many coming out of chemo. One would think that the transplant team would see that as a benefit.

Maybe things will change in the future.

to evaluate drug interactions (and know the regimen the patient will be on), I don't believe you can make that assessment.

As noted below, licorice is (or can be - I don't know that it is on all lists) prohibited while on the liver wait list because of its impact on the liver. I had forgotten that since it is not something my daughter eats anyway.

The body is designed to attack and destroy foreign objects. With the liver (and at least some other organs), both the body and the liver try to attack foreign objects. For the body, that is the new liver. For the liver that is the new body. Keeping the body, or the new liver, from doing the job they are designed to do in order to keep us well is extremely difficult and requires a small pharmacy of drugs - each of which interacts with other drugs (including over the counter) and - basically - anything you consume.

I don't know whether there are drug interactions that keep marijuana on the prohibited list - but I do know that l am not qualified to assess the interactions of marijuana with the pharmacy of drugs that will need to be started without notice, or time to clear the system of any drugs that would interact.

I just feel the occasional need to agree on some level with the reactionaries around here so you don't get immediately banned for lack of liberal fealty.

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.

but Cedars-Sinai may have failed that patient several ways:
1) the oncologist should have been aware of the transplant program rules
2) the transplant doctor should be able to share data and *shudder* actually consult with other physicians managing the patient before making a decision to remove the patient from the list.
3) the transplant program rules should explicitly discuss medical marijuana since there are states like CA where it has become normalized.

I realize that there is an acute shortage of donor organs and there is something to be said for steering clear of patients who won't or can't comply with the post transplant care but limiting the eligibility needs to be done on a consistent and scientific basis.

Almost entirely according to the MELD score (lab number + weighted for current dialysis patients) with some weighting for regional location.

Unfortunately, there are no scientifically valid means of determining out of all the people eligible based on their MELD score, which ones will be able to care for the organ after donation. That is the reason less objective - but closely related - criteria is used to sort that out just to get in the door to be on the list (or remove you from the list).

A patient who is caring for a liver post transplant cannot, ever, count on others to tend for her care. She will always have to be careful about drug interactions, making sure every physician knows what medications she is taking, and so on. Even before transplant, for my daughter, that means when her gynecologist prescribes flagyl for a yeast infection she cannot rely on her gynecologist's assessment about whether flagyl is safe, she must also consult her hepatologist to make sure he approves. And she is not even listed yet.

The patient is the person in connection with all pieces of the system, who has access to all of the information. She is the one responsible for communication and she needs to demonstrate that she can make sure, for example, that any future oncologist who may - or may not be part of the same system - knows all of the relevant medical information. Including restrictions of any separate medical treatment like a transplant.

If the patient cannot understand and communicate clearly with every doctor caring for her and follow the rules of the transplant program in advance, when she is near death and she more tangibly understands her life depends on it, it is less likely that she will be able or committed to do so when life is once again good. That is just reality, and unfortunately there is no objective or scientific way to sort that out - even though the ability to communicate among physicians and to follow the rules of the transplant program are not direct indicators of post transplant care, but they are very closely related and are about the best that is available.

As for medical marijuana - that is where the patient needs to advocate for a personal exception. By doing that, she demonstrates her ability to be medically compliant - buy communicating her needs clearly, by working with the system to design a plan suited for her needs, and by ultimately following her doctor's orders (even if that means foregoing medical marijuana if she is unable to obtain an exception).

My daughter has a liver disease that is completely unrelated to alcohol - and is patchy (meaning she has healthy portions of her liver intermingled with unhealthy - and the healthy portions are no more susceptible to injury by alcohol than any normal liver would be. Her transplant physician has told her, for now, that she shouldn't drink alcohol - but that realistically she is in college and his expectation is only that she will drink it sparingly. About half of the physicians treating this disease permit a few alcoholic drinks a week. Regardless of his current position, that will change once she is listed. At that point, she will have to comply with rules even though they may be medically inappropriate for her as part of demonstrating that she ought to be eligible to receive one of the organs which are in limited supply.

For the record, she doesn't drink. At all. I'm just sharing that as an example of other similar restrictions that have nothing to do with the legal or illegal status of the material being consumed, or the medical impact of using it, but which would bounce her off the list if she violated the rules.

It is always very helpful when my daughter's doctors communicate well with each other - particularly those in the same medical system - but the reality is that rarely happens and ultimately we are responsible for making sure there is no mix-up, just as she will be post transplant.

I am far more concerned about economic disparity in becoming eligible for the list than I am about disqualification based on things under the recipient's control. Many individuals cannot demonstrate that they have the economic means to care for the organ post transplant (anti-rejection drugs are not cheap), and are ineligible for that reason - and that seems to me much more unfair.

My sister and I had to have a long consult with a financial expert who advised the transplant team to ensure all of her expenses would be covered. She had to provide financial records, bank statements, medical insurance cards, POAs etc. All of it upfront and if you can't cover any part of it, you will not be accepted onto the list.

its more than just the anti-rejection drugs cost-wise. A transplant recipient must stay within walking distance to the hospital and the transplant team until her bloodwork is stable. In my sister's case that meant renting an apartment in San Francisco near CPMC, a very expensive neighborhood, for two months. She was allowed to go back to her hometown after that (3 hours away) but had to have the financial ability to get back to San Francisco every week for the next 2 months staying overnight in a hotel. So even if you have adequate health insurance to cover the medical costs, you need $15 - 20k in a savings account as well.

A personal note to you Ms Toad: your daughter is very wise to stay away from alcohol even now. My sister had to have been alcohol free for the entire year previous BEFORE she would be considered for the transplant list. Like your daughter she also was not a drinker so she got on the list much faster because she wasn't waiting out that year. My sister contracted Hep C as an RN student so her liver was already compromised for most of her life (and was a big reason why she didn't drink). She then coded during a colonoscopy which destroyed her liver AND kidneys. So the "final" destroyer can sometimes take place very rapidly and unexpectedly. Best of luck to you and your daughter...

Friends (with this disease I have around a dozen friends who have been transplanted), have had to have more than $100,000 just to demonstrate they could pay for the anti-rejection regimen afterward. And the live-away from home - one friend is going on a year living away from "home" in order to be close enough to the transplant center for when the call comes.

Small world. I have a SIL who contracted Hep C as an RN. Careless docs left a needle from an infected patient in the bedsheets - and then the facility told her (and treated her for) Hep A. She found out about 20 years after the fact, when she had significant cirrhosis of the liver, that it was Hep C. Of course, we can't talk about that because of the settlement

Fortunately, she is doing well - and my daughter inherited a great hepatologist since her aunt had already scoped them out by the time of my daughter's diagnosis.

My daughter's progression is likely to be slow. It is the nature of the disease - and I'm sure you know well what that means about her quality of life until she is finally sick enough that living with someone else's liver is less risky than continuing to life with her own. Not to mention her current medical costs of around $45,000 a year until that time that someone has to cover...sitting on pins and needles until the Supreme Court decision.

1. There are other ways to stimulate appetite than marijuana. I'm going to guess Toni Trujillo was given several options and chose the mj. I don't know that but I do know that there are other ways to stimulate appetite without mj. Regardless, Ms Trujillo signed papers - a lot of them that were explicit from her transplant team that she was not to take any drug/food/medicine or herbal supplement without checking every substance with them first. Even candy is checked against their chemical lists to check for toxicity and chemical reactions. EVERYTHING is checked when you go on the transplant list.

2. The transplant team were now her primary physicians as soon as she went on the list. Her oncologist would have been secondary (weirdly enough). Ms Trujillo knew that explicitly as well - that the transplant docs were now her #1 docs and have exclusive control over managing the patient's care. It just has to be that way since the body chemistry required for the transplant to succeed to staggering. The pharmacy on a transplant is breathtaking. Nothing, not even one Twizzler is allowed to go without being checked. The dietician goes over ALL of your food choices and if you deviate you can be thrown off for having Twizzlers (I kid you not. Licorice is strictly forbidden).

3. The transplant rules in CA explicitly forbid mj, alcohol and tobacco. Its in the protocols numerous times and you have to initial that part at least 5 times. Not only that it's reiterated verbally multiple times.

Having not been through the listing process yet, I can't speak authoritatively to what is in the orientation and contract portion of it.

What I do know from having spoken more generally with a number of transplant physicians and recipients and (ironically) being in the middle of editing an article on living donor transplantation, is the theory behind the strict adherence to rules even when there may be no medical prohibition.

"It appears Trujillo and Smith may eventually be put back on the list, but at the bottom."

All organ allocation of livers is based on the MELD score, with a bump up for being on dialysis, and with local and regional distribution, and organ compatibility taken into account. The MELD score predicts who is most likely to die within 3 months. If Smith has a high meld score, he will be at the top on the list at the moment he is placed back on the list . Time on the waiting list has played no role since UNOS switched from using the Child-Turcotte-Pugh score in 2002 (where time on the waiting list and admission to the ICU both played roles which could be gamed by clever physicians). So once back on the list there is absolutely no impact to having been removed from the list.

The reporter may well have been doing the best job he could, in a complex area, but since he fundamentally misstated the impact of having been removed and then returned to the list, I would be cautious about taking anything else reported on at face value.

to you and riderinthestorm for sharing your knowledge of the process.

which reminds me I need to incorporate a donor bug in my sig line I had one as my avatar on DU2...

People like you have no moral compass.

"support team" I went to all of her pre-transplant visits, exams, counseling sessions etc. so I'm well aware of the rules and regulations.

1. When you are listed for a transplant, your transplant team becomes your #1 physician team. Nobody else matters. Nothing else can be prescribed or administered without their permission and you sign paperwork to that effect. This is to ensure you are medically compliant AND to ensure your body is as chemically balanced as can be before the surgery since balancing the rejection issues and post-surgical trauma chemistry is incredibly complicated. The patient's bloodwork is often tested 2x/day for the first couple of months as they fiddle with it. Even food intake is highly scrutinized and the dietician is a critical member of the transplant team - so critical that the dietician alone can get a patient thrown out of the program if they aren't compliant.

2. Toni Trujillo signed many, many papers that advised her of all of this I assure you. Not only that but the transplant team social worker goes over the agreement line by line verbally, ad nauseum so there's no mistake. The "support team" family members are also given strict instructions on these protocols. If she went outside the transplant team to get a medical marijuana rx she was already not following one of the main directives which is to run every single thing through team.

3. There isn't a transplant team on the face of the planet that will allow marijuana (or alcohol or tobacco). My sister's transplant was done in San Francisco but we looked into having it done in Chicago since most of us live here. The protocols were the same.

4. There are other substances like prednisone that are administered to ramp up an appetite. My sister had severe nausea from the anti-rejection drugs and there are other things that can be prescribed to assist.

Organs are a precious, rare commodity. Complying with the transplant team's directives is an easy way to screen out those who aren't 110% committed to doing everything necessary to facilitate success.

The article was not clear if this was some type of federal regulation, or just the policy at this hospital.

for that hospital. The protocols for transplant are fairly uniform throughout the US with very little deviation.

I'm not qualified to know that's the main issue but I would hazard a guess that it is.

Organs are rare and precious. The transplant teams want every single transplant to be successful. If you can't be compliant, in writing, and in reality, then they won't take you.

I presume the contracts with the hospital transplant teams are necessary because there have been those who've cheated.

And you can't cheat. The anti-rejection drugs and other meds for maximum success are too complex. The post-transplant pharmaceutical list is staggering. If you bothered to read any of the above posts, even some innocuous items like candy can destroy the organs.

Did you read that? Even candy can be problematic. This isn't any kind of a judgement about mj. Its about the transplant and maximizing transplant success. If you're a cheater, you won't be successful so why the hell should they WASTE a kidney/liver/heart or whatever on someone who won't follow the med protocol?

Right. Quite slick.

I fully support decriminalization and you won't find a single post on DU where I support the Drug War, ever.

That's a lie.

This thread is about transplants, not mj, no matter how much you or anyone else want to co-opt it and make it about that

Edited to add the link from earlier this year about my sister...

http://www.democraticunderground.com/101844528

It comes from your advocacy.

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=799637

I am not an advocate of anything. I simply have a 15 year old with a severe substance abuse problem (whereby I have been immersed in substance abuse group and individual counseling through the rehab facility) and a husband in remission from lymphoma (so I have many friends and acquaintances who use medical mj for relief).

I will state it again, I am not a supporter of the Drug War. Its a grotesque waste of resources and should be stopped immediately.

It was an analogy only. But please proceed to kick the thread. Its got important info and I'm happy you're helping.

of owning it. It's not convincing.

of imminent death. Regardless, she simply has to use alternative appetite stimulants instead of pot and she goes right back on. Most likely in the exact same spot since her place is determined by her MELD score and not time (but of course you would have known that if you'd read any of the preceding posts).

Compassionate people would advise her to use a different appetite stimulant and get back on the list.

Organs are allocated through a national network (UNOS) and rules, with some priority to local or regional need. Listing is the process of becoming eligible to receive a liver. Even individuals who are using a live donor must still be listed. Neither of the individuals is currently listed so there would not be an organ available to transplant.

The first step is to become listed again (apparently after a mandatory 6 month ban - which, incidentally, is the same dry period typically required for alcoholics who require a liver transplant because alcohol has destroyed their own). I did not see a prohibition in the OPTN rules based on marijuana use - so I don't know whether there is a firm listing barrier. If you want to explore on your own, the rules are here

Once listed (again) they will be eligible immediately for an organ, based on their need. With livers, it is based almost exclusively on the MELD score (Model of End-stage Liver Disease). There are some variations in listing criteria from center to center.

local businesses

when asked to contribute i say firmly
no thanks--those bastards have enough of my money.

i have been asked to elaborate and i do

hit em where it hurt-in the wallet

If you don't believe the two of us in the thread who are telling you from our direct experiences what the concerns are that this policy addresses, please do some independent research rather than assuming that removing these people from the list was an abuse of the system.

As I pointed out earlier, there are significant errors in the article - including false allegations that make the actions seem more outrageous. Two of these are:

One of the recipients was just two months from transplant. An individual may receive "the call" anywhere from the day s/he is listed to years later. Once you are listed, there is a continuous re-evaulation of your status. For livers, as your MELD score goes up or down (and it does change over time) you move closer to being the one in line for the next liver - or farther away. There is just no way to predict how far away you are from getting the call.

If they go back on the list the go to the end of the list. Same error. Position on the list has absolutely no relation to how long you have been on the list. Assuming the individual's condition deteriorated while off the list, they could well be eligible for the next available compatible liver on the day they are re-listed - even if there are people who have been on the list continuously for years.

Those aren't the only objective errors in the piece - so anything else the article says should be viewed skeptically. So please, investigate for yourself, before you decide to take yourself off the donor list.

calculus, were they?

The criteria is objective.

My sister was #3 on her list (B- blood type, double organ transplant). When the organs became available she got the transplant because the first two people were too ill to have the surgery that day. What may have had the appearance of "favoritism" (she's a prominent mental health professional in CA with a very powerful state position), was just the way the cards were dealt THAT DAY.

I don't know the exact particulars of the organ transplants for any of the celebrities you mentioned but whatever happened in the past has no relevance to today's operation. The MELD score pretty much trumps every other factor and its as objective a criteria as you can design.

Organ donation should be a voluntary gift. While I certainly can't make anyone stay listed as a potential donor, its important you and your family are 110% comfortable with it.

"I don't know the exact particulars of the organ transplants for any of the celebrities you mentioned"

Google first. Hold yourself out as an expert second.

Go Romulox! Double kick! Perfect! I could do this forever... please continue.

It's because of your "even handedness", no doubt.

None of us does since that's private patient info. I can only tell you what the criteria is, explain my very, very recent history with this and how its impossible to cheat the system. Its imperative that anyone considering being a donor has a full and complete picture. People are dying because of misinformation like you are trying to spread as they remove themselves from the donor list over untrue statements they've read on the internet. Please. Don't spread misinformation - that's my point.


Thanks for the kick!

Instead, like many internet "experts", you went straight to lecturing.

"Thanks for the kick!"

I don't think you understand how repulsive this behavior (and its justifications) are to many. Thanks indeed.

You have no idea how ignorant and repulsive you sound to many who are desperate for an organ, and who would gladly do what is required to ensure the health and longevity of this great gift.

protocols as specified because of the potential drug interactions and medical complications post-transplant.

This isn't really about pot (much as you and others want to make it about that). Its really a non-compliance issue. She could be eating Twizzlers and get kicked off just as fast (and be put back on in the exact same spot as soon as she quit eating Twizzlers).

So unreasonable and disgusting...

Ms Toad has outlined the protocols for how a person gets placed on the transplant list in her excellent post #35. There's no way to cheat unless the patient's entire transplant team is colluding (my sister's team included two surgeons, a cardiologist, a hepatologist, a nephrologist, a dietician, a psychiatrist, the transplant coordinator RN, and the social worker). I guess an entire team could be "bought" but that ranges into the delusional in my experience. It wouldn't be worth it - jeopardizing the UNOS system and the legitimacy of the programs would be fatal.

The transplant teams have a vested interest in making sure their patient is going to survive - not only because they're medical professionals who presumably care about their patients, but because survivability rates are crucial for the doctors/hospitals reputation and future. They are going to select those that ensure the most potential for success, not because you are Larry Hagman.

I hate the man with a passion but with his history of heart problems, I'm sure he had a very, very high score.

who have also chimed in to correct you. But since you are clearly stalking my posts (which I don't mind, anything to boost awareness), haven't read anything that's been posted, have resorted to lies and misinformation repeatedly, I'm not surprised you also believe I'm the only one on this thread speaking on this topic.

"The criteria is objective..."

Yes, it most certainly is. And the appeals to emotion have little to do with that set criteria which seems to piss off a lot of people. You have/had a sister on the list, I had a brother on the list and know that regardless of what we'd like to see happen, there are protocols that must be followed to remain.

I would suggest to anyone who feels the criteria is irresponsible or counter-productive become engaged in MMJ from this end rather than simply getting angry and throwing tantrums.

Each set of diseases have different sets of criteria. Heart transplant patients may not eat chocolate or many varieties of nuts, skin graft recipients may not use most types of bar soaps, etc., and get removed from the list if they do use these substances.

Al things being equal, I'd only be guessing as to why or why not MMJ users are removed from the list, as it seems, along with most people on this thread.

I would need access to their medical records and the UNOS lists at the time, but being unfortunately intimately familiar with the process, at least in recent years (since they went to a model which allocates organs on the likelihood of death in the near future) I would be extremely surprised if they were allowed to jump the line. For livers (where I can speak with some authority), since 2002, this is how they are allocated: MELD score (a combination of 3 lab values + a bump in score for being on dialysis). Beyond that score, geographical factors kick in to determine whether the available liver stays locally, regionally, or is shared nationally.

Just because famous people receive organs doesn't mean they are receiving them ahead of others who are not famous but sicker. It only inherently means that it makes the paper. There are people who die on the waiting list, but far fewer (waiting for liver) than prior to 2002 when it was easier to game the system if your doctor was saavy about the scoring. Would you deny all famous people the right to be in the organ pool merely to avoid the appearance that subjective criteria are being used?

Just for comparison, my next door neighbor's daughter received a heart and lung transplant in the same time frame as Cheney did. My neighbor has an elementary school education, was a great grandmother well before she was 60, and never earned much more than minimum wage. I don't know all of the daughter's details, but I do know she didn't fall far from the tree. I know a number of people who are receiving liver transplants who are on SSD or SSI. Her waiting time (based on my recollection) was shorter than 6 months - I believe it was shorter than two, but without checking with mom I can't be sure.

In contrast, here are the public details on Cheney's Virginia transplant: The median waiting time for individuals over age 64 in the region containing Virginia was 1.7 months (during the most recently reported data period). Nationally, the waiting time was 5.6 months (same source). This was the first heart he was offered during the 20 months he was listed.

There are ways that money influences the system, but not in the cut to the front of the line sense.

• Listing in multiple regions is permitted. This means (for livers, I don't know that it holds true for other organs) that we will probably list our daughter in Florida where the waiting list is shorter - in addition to wherever she lives at the time. People without means cannot generally afford the travel or living expenses associated with being listed where they do not live.
  
• In order to get on the list, you have to demonstrate your ability (including financial) to cover the costs of the transplant and to maintain the organ you receive. That can be via SSD, SSI, or insurance - but it is challenging. Many people raise money to generate a pot of money to cover costs and the first post-transplant period of time. Obviously, this is easier to do for people with means than without.
  
• You also have to demonstrate the social support system to care for you during recovery - including an extended recovery which may be out of state.
  
• For organs for which live donors can be used, people with means are probably a lot more able to find willing donors who are able to take the time off work, potentially without pay that is required of a donor, or to have had access to the kind of medical care that would have left potential donors in good enough health to make the cut.
  

In fact, that is one of the things my friends sometimes complain about when they want to get away with doing things on the sly - but that really has nothing to do with this issue.

I took the allegations of abuse seriously enough to verify everything that I can about one of them (Cheney) without access to his medical records (or the others on the waiting list). Nothing screams abuse - in fact the opposite. Based on what is publicly available it looks as if he waited 11.5 x longer than the average person his age in his region.

Do you have anything beyond a one line dismissal to support your assertion that his far longer than average wait time should have been even longer? Do you have special knowledge that strings were pulled, or that someone else should have gotten the heart he received? If so, I would love to know what it is - because my daughter's life depends on the system being fair, and I am actively working to make sure the system and rules are as fair as they can be - as I actively worked on insurance reform to try (in a lousy model) to make sure that access to health care was tied as little as politically possible to access to money.

Have you, for example, even read the guidelines for organ allocation? (I have, for livers - and I also skimmed the guidelines for hearts to make sure they were as objective as the rules for allocation of livers, and they are.)

Have you participated in the public comment period for the rules when they are up for review if you have concerns that they are being abused? (I don't have concerns that they are being abused - although I do believe they need tweaking because - for example - not all liver diseases are identical even though the UNOS rules treat them identically - and I have participated in the process to advocate for tweaks I believe would make the system fairer.)

If you are not willing to put the effort into understanding how the system is supposed to work and fixing whatever inequities you see in how it actually works, please at least stop discouraging others from donating.

The shortage of organs is really the only reason the abuses you believe are happening make any difference. If there were more than enough organs around, we wouldn't care who was at the front of the line. And, even if you are correct that there are abuses in the system and even if they never get fixed, the rich and famous cannot consume 100% of the organs available. Shutting off the supply just means that there will be fewer organs left for the rest of us after (as you seem to believe the system works) the rich and famous get theirs.

Turned out to be a very informative thread.

it would not go to this fucking hospital. Thats for sure.

If you become an organ donor, you would have no choice where your organs went. They go to the next designated person on the transplant list and you'd be saving someone's life.

different from someone buying from a dealer on the streets illegally? Or is it now that ALL people that smoke MJ are unwanted vagabonds?

as will alcohol etc etc. This is about compliance with the transplant protocols and potential drug interactions with post-transplant medications.

it to be hazardous to the transplant process? That is a surprise.

I really wouldn't waste my time doing so. Seems kinds strange, but OK.

My sister just got her kidney/liver transplant in February. I truly didn't mean to come off so abruptly.

I feel for the women in the OP but if she wants to stay on the list, she has to comply with the protocols. There are other appetite stimulants she can get from the docs.

Actually let me be the one to say I am Sorry, I forget how some of these issues are on-going with many DUrs here. I have to agree with lanternwaste...all we are doing is guessing as to why MMJ is off the list and nothing more.

This is obviously a very emotionally charged issue.

Here is to your health and your sister's health, may you both live a long and fruitful life.