My sister underwent a bone marrow transplant a little over a year ago. One thing I learned in watching her go through the process is how incredibly demanding, stressful, debilitating, and completely structured your life MUST become during and after transplant. She gained huge amounts of weight initially, then lost over a third of her body weight after the transplant as she was unable to eat, which was very stressful in itself. She fought severe depression during the process. She lost her short term memory completely due to a virus that attacked her brain. She had over 40 pills to take each and every day at very specific times. She had to be at the hospital for 35 days initially, and then every other day after discharge for extensive bloodwork and treatments. There is a list several pages long explaining everything you can and cannot do, from foods to eat to when you can have sex.

Honestly, I can completely understand how people with severe mental illness should be excluded from the transplant list. I read constantly here of people who willy-nilly just stop taking their meds, who are unable to handle the stresses of everyday life, who cancel appointments because they don't feel up to going, who don't follow their doctor's expressed orders because they think they know better. You CAN'T do those things in transplantation. That would be a HUGE waste of an organ. It may seem unfair, but the transplant list is a long one, and there are plenty of candidates out there who are able to deal with the process and with the protocols for transplantation. There are many reasons for exclusion from the transplant list. Mental illness issues are just one of many criteria.

There are no guarantees in transplantation. My sister was an ideal candidate. She did everything that was asked of her to the letter, but still there were complications. Even under the best of circumstances things can go wrong. My sister died after months of deterioration. They have to limit who they offer transplants to because even in the best of circumstances, things don't always work. They have to at least offer the transplants to candidates that show the best chances of survival. That's just the harsh reality of supply and demand. If people really want to open up the pool of candidates for transplantation, then many, many more people are going to have to be willing to donate organs. Until that happens, the system will have no choice but to continue as it is.