My alcoholic boy, facing death at 22
Gary Reinbach started drinking alcohol with friends when he was 13. Now 22, his is one of the worst cases of cirrhosis of the liver among young people that his doctors have seen.
His predicament may serve as a wake-up call to a generation of young drinkers who are downing large volumes of cheap alcohol.
Doctors at University College hospital (UCH), in London, have given Reinbach the most advanced therapies, including a one-off treatment with an artificial liver from San Diego, California. But all have failed and they believe only a transplant will save him.
Reinbach, from Dagenham, Essex, does not qualify for an organ because official guidelines state that heavy drinkers must prove that they can be abstinent outside hospital before they are considered. His condition is so severe that he cannot be discharged to prove he can remain sober.
His mother has chosen to speak out in an attempt to reverse the verdict that he is not entitled to a liver transplant, which would give him a 75% chance of survival. Without one his chance is about 30%, according to his doctors.
Madeline Hanshaw, 44, his mother, said: “Gary didn’t know what he was doing when he was 13. He didn’t know it would come to this when he was 22. He didn’t know he was going to die. All his friends who were drinking with him are still at home, they are fine.”
Hanshaw, who works as a kitchen assistant, says she worked full-time when her son was growing up and was initially unaware of the extent of his drinking. This is the first time he has been hospitalised for alcohol damage.
One of Reinbach’s doctors, Professor Rajiv Jalan, a consultant hepatologist at UCH, said: “This is a young man who has never known any better. He has been drinking for eight or nine years and did not see what was coming to him. We feel this boy deserves a transplant because it is the first time he has come to the hospital with an alcohol-related problem.
“Most of us feel that if the patient has been abstinent for a period of time, and not a repeat offender, they should be given an opportunity. The debate is whether there should be exceptions to that rule.
“Gary has been in hospital for 10 weeks now and is teetering on the brink of death. He is in a catch22 situation because, if he does not get better, he is going to die in the hospital. He is never going to have the time to demonstrate he has been abstinent [outside hospital].”
There was an outcry when George Best, the late Manchester United footballer, was given a liver transplant in 2002, only to return to binge drinking within a year. He was criticised for putting people off organ donation. More than 8,000 Britons are awaiting an organ transplant, 259 of whom require livers. More than 400 people died on the waiting list last year.
The shortage of organs has been exacerbated by them being given to overseas patients who pay for the transplants. This year the health department was forced to investigate after it emerged that in the past two years the livers of 50 British donors had been given to foreign patients.
Binge drinking among young people has led to a sharp rise in deaths from cirrhosis of the liver in the 25-34 age group and hospital admissions among young people have been increasing. In 2007-8 the London Ambulance Service NHS Trust dealt with 8,126 alcohol-related calls for 11 to 21-year-olds, a 27% increase on 2004-5.
Reinbach’s doctors say cheap alcohol has contributed to the crisis. Raj Mookerjee, a consultant hepatologist at UCH and another of Reinbach’s doctors, said: “Young people can readily avail themselves of cheap alcohol in large volumes.
“Gary was drinking when his mother thought he was at school. He was drinking with several other people. In less than 10 years he has developed advanced cirrhosis. This backs the suspicion we have had for a long time that the liver is more susceptible at a young age.”
Reinbach enjoyed playing football and golf when he was younger but these sporting outings turned into binge-drinking sessions.
Hanshaw added: “I think it is too easy for young people to get alcohol. You can buy a bottle of whisky for about £7.”
A spokeswoman for NHS Blood and Transplant said: “This case highlights the dilemma that doctors [face] because of the shortage of donated organs. They have to make tough decisions about who is going to get the most benefit and who is going to take best care of this precious gift.”
source: The Times
