How does the system allow this?
Good luck to the OP.
The specifics on this issue aren't privy to me. In this case it was the estranged husband of an old high school classmate who was suicidal over his wife leaving him. Perhaps it was his only attempt, and not a repetitive pattern of behavior. I answered my classmates questions and didn't pry.
Believe it or not, the science shows that addicts (drunks and drug addicts) who can remain sober are usually good candidates, and typically do better in post transplant care than folks with other pathology failing their liver. I sat through a two day CE seminar on this very issue a few months ago. But I would not be able to look a mother in the eye and tell her that her dead son, who was killed by a drunk driver, would be giving his liver to a former alcoholic with end stage alcoholic cirrhosis.
That being said.
I have made a personal choice not to work in transplant medicine because some of the things I have been PERSONALLY privy to over the years in various roles in ICU and interventional cardiology as a nurse... I would have a hard time accepting some of the things I saw and putting my name to it facilitating it... Given it would be my professional duty to treat without regard to my prejudices, I don't put myself in that position.
For instance.. I've cared for:
A person over age 60 who had a preoperative complication during their THIRD heart transplant and had an anoxic injury.... (and people waiting for their first....)
The night that there were two lungs and a heart available, and only two transplant teams, and at some point after it was too late to offer the heart to someone else and have their transplant team come in..... the two lungs were split to two separate single lung recipients instead of a single recipient of a double lung. There wasn't a third surgical team for the heart. It went to waste. Sadly, had the neighboring transplant team from a few miles away been aware, they could have had their patient in-house and ready. The at fault program got probation.
Then there's the way that some transplant surgeons fudge the acuity numbers or set the donor parameters for potential offers way outside the range of appropriate to increase potential offers (which would then be declined in most cases...) ... or depending on the organ, list early in disease in order to maximize calendar time and put folks at the top of the list on those that was primarily calendar-priority rather than acuity-priority lists
Then there was the long ago story of Jesica Santillan (
http://en.wikipedia.org/wiki/Jesica_Santillan).. in which i have no personal firsthand knowledge. Organs are rare, and we are giving them to foreigners when we don't have enough for our own citizens... never mind the MIND BOGGLING foul up that brought her situation into the public eye in the first place (type incompatible transplant resulting in hyper acute rejection)... people were dusting off old textbooks to figure their way out of that one, such a thing having not happened for decades...