Getting an organ for transplant is not a simple task, and for one Utah man, a months-long delay brought on by the detection of THC in his system proved to be deadly.
Nineteen-year-old skier and cyclist Riley Hancey suffered a particularly bad case of pneumonia last Thanksgiving that got him admitted to the University of Utah Hospital and placed on life support by December 2nd. He was set to go on the transplant list to replace the lung machine he was using when his eligibility for the organs was suddenly denied, apparently because of the presence of the cannabinoid tetrahydrocannabinol (THC) in his system.
The Salt Lake Tribune writes:
“[University] officials said they could not comment on his individual case, but spokeswoman Kathy Wilets said under the hospital's transplant policy, ‘We do not transplant organs in patients with active alcohol, tobacco or illicit drug use or dependencies until these issues are addressed, as these substances are contraindicated for a transplant.’ Patients remain ineligible at least until undergoing a treatment or cessation program, Wilets added. The policy is designed, she said, to give patients a higher chance of surviving surgery and recovery.”
THC is well known for being stored in fat cells, shown in animal studies to be released back into the blood in moments of food deprivation or stress (and, in a human study with a very small sample size, during exercise). Theoretically, the substance can be detected in urine after as long as 77 days of abstinence, and it’s self-evident as to why a trace level of THC is not in and of itself indicative of a substance abuse issue the way that the University of Utah implied in its rejection of Hancey’s transplant request. The “contraindicative” drug tests that the hospital was looking for could have taken months—even with Hancey bedridden and clearly not abusing drugs, and even if he’d gone through a treatment program for his non-existent issue.
Hancey’s father, Mark Hancey, said that his son had been drug-free for a year before deciding to smoke once with his friends on Thanksgiving, but this wasn’t enough to placate the University of Utah. After two months of searching for a different hospital that would admit him to their list, Hancey was moved to the Hospital of the University of Pennsylvania where he was finally able to undergo the double lung transplant on March 29, only 18 days after arriving at UPenn and apparently to no protest by spokespersons.
Unfortunately Hancey passed away just after his twentieth birthday last week, and though the delay may not have been the direct cause of his transplant’s failure—though that’s a case to make—it did mean a hospital bill of over $50,000 left over for his family.
Hancey’s is hardly the first instance of being needlessly denied an organ because of a distorted perception of high risk in recovery; 27-year-old Paul Corby, for instance, was denied a heart transplant in 2011 “because of his ‘psychiatric issues [and] autism,’” apparently being cited for “carry[ing] a doll.” The hospital that denied Corby was UPenn’s, the very place that accepted and did Hancey’s double transplant before his death this year.
If the guidelines for even a single hospital’s transplant requirements seem contradictory, it’s because they are designed to be vague. David Goldberg, medical director for living donor liver transplantation at UPenn, detailed his rather sober belief about the spike in organ denials following 2007, explaining to the Washington Post that “maybe centers are making the internal decision of trying to choose the best candidates.”
Hancey’s case has spurred a discussion of making such internal decision-making transparent and keeping it in line with modern drug policies and what we know about substances like cannabis. David Klassen, the chief medical officer at transplant waiting management group United Network of Organ Sharing, told the Salt Lake Tribune that transplant centers must “try to come to some reasonable judgments on the risk of marijuana use and the benefits of transplantations. […] Social and legal policy across the country is changing quickly, and I think transplantation and medicine in general need to keep up with what is going on and make appropriate decisions.”
With a number of patients being denied transplants specifically because of cannabis use—as well as data emerging that suggests cannabis helps the body keep from rejecting grafted skin and possibly even organs—it’s more important now than ever that transplant centers heed Klassen’s words and update their definitions of what drug dependency looks like. Lives certainly depend on them doing so.
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