VANCOUVER—A Vancouver widow says her husband, who died in August while waiting out a six-month alcohol-free period to be eligible for a spot on the transplant list, was told the policy could not be changed by the very same doctors who said last week it had been eliminated months before.

Gagan Grewal says her husband, Gaurav Chopra, was told by doctors from BC Transplant that the six-month period of abstaining from alcohol required for a spot on the liver transplant list was a strict policy. According to his wife, Chopra, who had been diagnosed with end-stage liver disease, had abstained from drinking completely since at least March. He died on August 3.

So Grewal said she was “shocked” to hear that the very same doctors at BC Transplant who told her husband that a six-month alcohol abstinence policy was unchangeable, said last week that the policy had been eliminated in May.

“With the emergence of new medical research and evidence we have been reviewing our clinical guidelines over the last year and in May 2019 we removed the alcohol abstinence recommendation from our exclusion criteria,” BC Transplant operations director Ed Ferre said in a statement last week.

The announcement from BC Transplant was made on Thursday after another man with end-stage liver disease filed a complaint with the B.C. Human Rights Tribunal over the alcohol abstinence policy. David Dennis said he’d only been sober since June, and was told that he did not qualify for the list.

Dennis received an apology from BC Transplant for the apparent “misunderstanding” and is now being assessed for a transplant.

Dr. Eric Yoshida, a gastroenterologist at Vancouver General Hospital and a member of the liver transplant program, told Star Vancouver on Thursday that the miscommunication with Dennis was “a complete mystery.”

Grewal said that her husband met with the Dr. Eric Yoshida as recently as July 11, who again told her that the policy could not be changed.

“It is so shocking that doctors can lie,” she said, adding she believes that the doctors either failed to take the necessary steps to treat her husband or have lied about the policy being changed in May.

Grewal expressed regret over not fighting harder for her husband’s treatment.

“I thought everything was perfect with health care in Canada,” she said. “You should not trust the doctors blindly. You should always fight the system.”

Grewal also sent Star Vancouver a thread of email messages between herself and hospital social workers assigned to her husband’s case.

In one email dated July 12, Grewal inquired about the six-month abstinence policy, explaining that it was hard for her husband to remember exactly when his last drink was, but that her father-in-law had made a statement about when he believed it to be.

A social worker with Vancouver Coastal Health responded to Grewal the same day, saying “the decision was not made solely based on your father-in-law’s statement, though it is true that the 6-months alcohol free period is critical.”

The Provincial Health Services Authority (PHSA), which oversees BC Transplant, responded to the information in the emails.

“In some patients with multiple health conditions, this need to reduce and stop alcohol consumption is even more critical when assessment reveals it is essential to stabilizing a patient pre-transplant,” said Vincent Chou, media spokesperson for PHSA.

“Organ transplantation is complex medicine and must be individualized in considering the patient from a wholistic perspective. We have to make decisions to consider transplantation based on individual care needs.”

Chou also told Star Vancouver that while they could not comment on Chopra’s specific case due to privacy reasons, the decision to move forward with a transplant “is not based on any one single factor, but rather, a multitude of medical and clinical considerations,” including “whether or not an individual is likely to survive organ transplant surgery in their current state of health.”

“Since the program started, a number of patients who have not abstained from alcohol have received a liver transplant,” Chou said in the statement. “More have been placed on the transplant list and many more have been assessed for transplant. It is very rare that a patient who has not abstained from alcohol for six months is not assessed, and if this has happened, it is generally for other medical reasons.”

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Asked about why no information about the policy change was available online, Chou said the guidelines were being updated and that all physicians were aware of the policy.

“The formal clinical guidelines and their associated documents are in the process of being updated to reflect the change to alcohol abstinence recommendation ... all the physicians and staff who care for patients at the transplant clinic know that the guidelines have been updated.”

He added that “when the guidelines are final” they will be available on the BC Transplant website and distributed to health authority partners.

According to Chopra’s brother, Amit Chopra, Gaurav began to show signs of illness in April 2019 after returning from a trip to India.

“His symptoms were all over the place ... they were not able to figure out what the problem was,” Chopra said in an interview.

According to Grewal, her husband was eventually diagnosed with end-stage liver disease requiring a transplant.

Grewal remembers her husband as “really lively, super energetic” person who was helpful to everyone he met. The couple had been married for five years. Chopra moved to Canada from India in 2013, and had been working as an international marketing director at Stenberg College in Surrey.

Since news of the policy change broke last week, patient advocates have spoken out about issues with communication regarding transplants within the medical system in B.C. and across Canada.

Debra Selkirk, whose husband Mark Selkirk died of liver failure in 2010 while waiting out the six-month abstinence period, filed a constitutional challenge against the abstinence policy in Ontario in 2015.

In 2018, Ontario launched a pilot program, which eliminated the six-month abstinence period for patients for a period of three years, in response to her challenge. Since then, she has founded the Selkirk Liver Society and advocates for patients with liver disease across Canada.

When she heard that B.C.’s abstinence policy had been changed, Selkirk said she was “pretty excited” but also in disbelief that the policy could have been changed so quickly.

Selkirk said she has been looking at legal ways to challenge the policy across Canada, which exists in all provinces except Ontario. She said she had not heard anything about B.C. changing their policy in May 2019.

“I’ve been chasing this policy everywhere as much as possible,” she said.

Selkirk said the policy change in Ontario took 18 months.

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