(7) alcohol heart transplants

(7a) Alcohol - dangers and issues

• Be able to evaluate evidence of some harmful effects of alcohol abuse:

  • a) in the short term -

    • Blurred vision - at high intoxication levels you don't see things clearly as normal and your sense of balance is affected - difficulty walking, impaired memory, slurred speech, in fact most mental and physical activity is interfered with.

    • Lowering of inhibitions - antisocial behaviour, from amusing to offensive actions you wouldn't normally do!

    • Slowing of reaction times - alcohol is a depressant and slows down brain activity - particularly dangerous for 'drink drivers' or 'pedestrians', you are more likely to be involved in an accident of some form or another.

  • b) in the long term -

    • Liver cirrhosis (liver disease) - many people do not appreciate the poisonous nature of alcohol which can be toxic with a large intake of high % alcoholic drinks. In small quantities, the liver can metabolise the alcohol into harmless by-products.

      • The liver is the site of break down of alcohol and other toxins to purify the blood (and the rest of your body).

      • However, high 'doses' of alcohol can cause the death of liver cells and scarring the liver tissue, eventually restricting the blood flow to the liver.

      • This inhibits the liver from doing its normal cleaning-filtering job of processing waste products from the body like urea.

      • Liver failure allows the build up of waste products like urea which may harm the rest of your body.

    • Brain damage - alcohol abuse is associated with widespread and significant brain lesions - permanent brain damage with potentially fatal consequences.

    • Alcohol is addictive - the more you drink, the more your body wants alcohol, therefore damage to your mental and physical health becomes more likely and more persistent.

      • With drugs like alcohol and heroin, you get addiction and withdrawal symptoms, an unpleasant physical reaction, when you stop taking the drug.

    • Consumption of high levels of alcohol also increases the risk of obesity, strokes, heart attacks and long-term anxiety and depression.

  • More on alcohol abuse and the general chemistry of alcohol (ethanol) (GCSE chemistry)

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(7b) Know about the dangers of solvents

• Organic solvents (NOT water) are extremely useful liquids for preparing solutions in the chemical industry and in many domestic products in the home including aerosols, glues, paints and cosmetic products.

• They are classified as drugs because they affect the brain and central nervous system e.g. they cause intoxication effects including hallucinations (illusions of the mind)

• Therefore solvents cause severe and negative effects on behaviour and character.

• The lipids and proteins in the skin are affected and reducing the ability of skin to protect itself - you can get dermatitis, sores and lesions and other skin disorders.

• Solvents can cause even more serious damage to the nervous system including the brain, liver, kidney and lungs.

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(7c) Cardiovascular disease (CVD)

• I've described and discussed CVD on other pages, see links below.

• So I've just added a note on the use of the drug statins.

• You should be aware of the use of statins in lowering the risk of heart and circulatory diseases.

  • Statins are prescribed drugs that help reduce cholesterol levels and research trials have shown they can have a significant effect in diabetic patients.

    • Increased cholesterol levels in your blood can lead to cardiovascular disease.

  • The statins drug trials were done using a large sample of people and half were given the drug and half were not.

    • Nobody knew who had the drug, half were given statins, but the other half, the control group, had a placebo - a substance containing NO medication.

  • Several independent studies like this 'blind trial' have shown that people treated with statins had reduced cholesterol levels.

The human circulatory system - including the causes and treatment of cardiovascular disease

See also the Keeping healthy - diet and exercise

and Respiration - aerobic and anaerobic in animals

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(7d) The use of organ transplants

• Be able to discuss the ethics of organ transplants when the organ is so damaged that a transplant is required to prolong life, including:

  • a) liver transplants for alcoholics -

    • Bearing in mind the acute shortage of organ donors (living or dead), should alcoholics with serious cirrhosis of the liver be given priority over someone who develops liver disease through no fault of their own?

    • A liver transplant patient should be expected to stop drinking before and after the liver transplant operation, otherwise why waste a valuable organ to be damaged by a transplant patient who will not stop drinking?

  • b) heart transplants for the clinically obese -

    • Obese people have a greater chance of dying during and after heart surgery and doctors can insist that the heart patient loses weight before major surgery is considered.

  • c) the supply from organ donors and ethical issues e.g.

    • Organs can be donated in advance by your own consent at your own death eg kidney donor card, though your family must be consulted too.

    • Organs can come from people killed in accidents or even from somebody declared brain dead, BUT without prior consent of the deceased, organ transplant consent must come from relatives.

    • Organs can be donated by living people e.g. we have two kidneys and we can donate one and live (with dietary care) very well on one kidney.

    • Unfortunately there is a great shortage of organ donors in the UK and so the medical profession is encouraging people to become organ donors in the event of their death.

    • The ethical issues are complex and whatever you think about whether a patient deserves an organ transplant, the medical profession basically decides on the basis of which patients are most likely to benefit from a transplant operation - sounds simpler than it sounds, it might not be just a medical opinion (the main factor), the likely patient's attitude post-operation might be taken into account too? (not sure on the last point? but alcoholics may be short on sympathy from the public? but the public doesn't decide!)

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