The dilemma of liver transplant allocation for alcoholic patients

Liver transplantation for alcoholic liver disease (ALD) has been, and continues to be, a subject of great controversy. Although ALD is one of the most common causes of cirrhosis of the liver and one of the most prominent indications for orthotopic liver transplantation, arguments arise regarding liver transplantation as a suitable treatment for this disease. In many documented studies, the rate of alcoholic recidivism and rates of noncompliance with antirejection regimens have been examined. Many of these studies demonstrate that the rate of recidivism is high and medication compliance is low. Now is a time in which medicine is experiencing an increased need for organ allografts with a profound shortage of suitable matches for patients in need. Therefore, transplanting viable and vital liver allografts into patients with ALD, considering high rates of alcoholic recidivism and noncompliance, is more ethically controversial than ever. It is the responsibility of the medical personnel-including nurses-who sit on ethical advisory boards to distribute an exceptional gift of liver transplants. Also, it is the duty of nurses who are involved with the care of transplant recipients to help the patients assume full respect and treat their liver well. This article discusses the ethical implications and ethical obligations of medical staff when continuing to consider ALD appropriate grounds for liver transplantation.