• When you deny a kid a heart transplant, you better have a good reason why

    My inbox is filled with emails about this:

    A Georgia teenager needs a lifesaving heart transplant, but his family says low grades and trouble with the law have kept him off the transplant list.

    Doctors at Children’s Healthcare of Atlanta at Egleston told the family of 15-year-old Anthony Stokes that they won’t put him on the transplant list because of his history of “noncompliance,” according to ABC’s Atlanta affiliate WSBTV.

    “They said they don’t have any evidence that he would take his medicine or that he would go to his follow-ups,” Melencia Hamilton, Anthony’s mother, told WSBTV.

    Anthony has an enlarged heart and has been given six months to live, according to WSBTV.

    I’ll admit freely that I don’t have a lot of information here by which to judge. But a few facts seem clear. The boy in question could be placed on the list. There’s nothing about his age or his condition that would prohibit his receiving a transplant. It also appears that the hospital isn’t denying the basic facts here:

    Children’s Healthcare of Atlanta spokeswoman Patty Gregory said in a statement, “The well-being of our patients is always our first priority. We are continuing to work with this family and looking at all options regarding this patient’s health care. We follow very specific criteria in determining eligibility for a transplant of any kind.”

    It’s entirely possible that there is a legitimate and defensible reason for denying the transplant to Anthony. But it better be a good one. We transplant adults all the time for self-inflicted disease. Alcoholics can still get liver transplants. Many of them return to drinking after their transplant. Poor past choices are not normally a good reason to deny someone a transplant.

    If you’re going to deny a kid a heart, you better be prepared to explain why. I hope people will continue to follow this.

    @aaronecarroll

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    • Noncompliance is a very appropriate and common reason to keep someone off the transplant list. Again, knowing nothing about the details of this case, I can’t comment. But organs for transplant are a precious and very limited resource. It makes sense for them to go to the patients who will benefit the most. If a given patient doesn’t take his or her meds, doesn’t complete the follow up and rehab regimen, and dies from heart failure or rejection, then that organ (and the donors’ sacrifice) was wasted.

      Noncompliance isn’t an absolute or permanent exclusion criteria, by the way. Its common enough for patients initially denied listing to qualify later by demonstrating willingness and ability to comply with treatment,

      • In kids? I’d like to see some numbers on how many children are denied transplants on those grounds. They’re all non-compliant in some way…

      • I have to wonder if the family is poor and couldn’t afford his medications in the past. This is just an assumption based on the fact that he is Black, but it is possible. Poverty is definitely a barrier to getting your meds filled.

        • In Georgia, Medicaid pays 100% of all drug costs on its tier 1 formulary.

          Perhaps the child is too “rich” to qualify for Medicaid, in which case the costs could be substantial. But if he is very poor, then the cost of the medicine would be covered at 100%

    • If you’re going to deny a kid a heart, you better be prepared to explain why.

      Which to me shows how corrupt our politicians (and maybe voters) are in that medicare pays for those 65 and older rather than for infants and children. The same dollars sent for infants and children would yield much better benefits. Old people vote, I guess.