The Transplant Committee
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Imagine that you are one of the members of a hospital committee that must decide which of 4 needy patients will receive a liver that has just become available for transplant. The liver must be implanted within the next 12 hours or it will become unusable. All 4 patients need the transplant, and are "good matches" for the available liver. These four people have a rare tissue type, and it is unlikely that another liver compatible with their bodies will become available for several months. The only information you have is that given on this sheet. After discussion, your committee must select the recipient by a majority vote. Be able to explain for whom you voted and why you did so.
Patient #1
Male, 65 years old, married, 4 adult children, wife is dependent on him for in-home care of a debilitating illness
Liver damage caused by cirrhosis resulting from long term alcoholism
Prognosis without a transplant: death from cirrhosis within 6 months
Prognosis with a transplant: should live a normal life span if he can quit drinking alcohol; if not, the cirrhosis will recur and the new liver could be damaged, although perhaps not within his expected lifetime
Patient #2
Female, 35 years old, married with 2 children aged 8 and 6
Liver damage caused by a chronic disease
Prognosis without a transplant: death from liver failure within a month
Prognosis with a transplant: should live a normal life for another 15 years until the disease destroys her new liver
Patient #3
Male, 21 years old, unmarried
Liver damage caused by eating a poisonous mushroom
Prognosis without a transplant: death within the week
Prognosis with a transplant: should live a normal life span free of liver disease
Patient #4
Female, 28 years old, married with 5 children aged 2 to 10, a legal immigrant farm worker
Liver damage caused by exposure to a toxic chemical sprayed on the fruit field in which she was picking produce
Prognosis without a transplant: death from liver damage within the month
Prognosis with a transplant: should live a normal life span
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original web posting: Thursday, June 8, 2000
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