Patients with severe alcohol-related liver damage could receive transplants for the first time, health officials in Britain said on Friday, re-opening the debate on who deserves the costly treatment.
The move comes after trials in France and Belgium indicated positive outcomes but the plan could put off potential donors who may not want to help those with what they see as self-inflicted liver damage or who could abuse their new liver with further drinking.
In a pilot scheme, the NHS aims to recruit 20 patients with severe acute alcohol-related hepatitis for transplant and assess the outcomes.
Officials insist those on the trial would not be on the "urgent" waiting list for a liver, and that the study would be "tightly controlled".
"We remain committed to being transparent and providing an allocation system that is based on clinical need and benefit and is not judgemental," said James Neuberger, associate medical director of the NHS's blood and transplant service.
"Until now, people with severe acute alcohol related hepatitis have not been given access to liver transplants. However, work from France , Belgium and other countries has shown that a small and carefully selected group of people with this condition do very well after liver transplantation."
Late footballer and heavy drinker George Best triggered a furore when he returned to drinking in 2003 just a year after receiving a life-saving liver transplant.
The number of livers donated has risen in recent years, but there is still a shortage of suitable organs.
The debate over who is eligible for costly medical treatments has grown more acute due to squeezed NHS budgets.
Alcohol-related liver disease caused 4,425 deaths in England and Wales in 2012, 18 percent higher than in 2002.