BC Transplant says misunderstanding led to liver transplant human rights case

BC Transplant says a misunderstanding about the guidelines concerning alcohol abstinence and liver transplants triggered a human rights complaint filed earlier this week by a B.C. man who has end-stage liver disease.

Ed Ferre, the provincial operations director at BC Transplant, said previous guidelines requiring patients to abstain from alcohol for six months in order to be eligible for a liver transplant were removed in May 2019.

BC Transplant, which oversees all aspects of organ donation and transplant across B.C., has contacted the patient, David Dennis, and says a transplant assessment is underway.

Ferre apologized "for any upset caused." 

Dennis, who is Carrier Sekani and Nuu-chah-nulth, alleged the policy had prevented him from getting on the transplant list as he had not abstained from alcohol in the past six months. He alleged the policy was discriminatory against Indigenous people who have disproportionately higher rates of alcohol use disorder due "centuries of racist and harmful colonial policies."

Dennis, the Union of B.C. Indian Chiefs, and the Frank Paul Society had filed the human rights complaint against BC Transplant, the Ministry of Health, and Vancouver Coastal Health on August 11. 

Jason Gratl, the lawyer representing Dennis, said his client was "delighted to learn that the [abstinence] policy is no longer in effect."

"If that occurred yesterday or it occurred in the spring, that makes no difference to him," Gratl said.

"The important part to him and to me is that my client is eligible for a liver transplant and that transplants are available in British Columbia on a non-discriminatory basis," he said, adding he wants to see a copy of the updated policy before dropping the lawsuit.

Debate led to policy change

Dr. Eric Yoshida, a professor of medicine at the University of British Columbia and a long-time member of the provincial liver transplant program, says there was almost a year of internal debate among B.C.'s medical community leading to a change in the policy this spring. 

The original policy was created through a consensus of transplant programs across Canada, based on research from the 90s. But new medical evidence shows that an absolute six-month abstinence rule is not supported, he said, which led to B.C. removing its policy. 

The decision to drop the policy means B.C. is leading the country in this area, he said.

"We were the first transplant program to see patients with HIV and we were leaders for many, many years before any other program finally caught up," Yoshida said.

"This is very similar."

In some cases, there is still value to alcohol abstinence, Yoshida said, since nearly all patients will improve their liver function by abstaining, but in B.C., there is no strict period of abstinence that patients must adhere to. 

"We really haven't refused to see anybody because of the six-month rule."