title: A psychosocial evaluation process for living liver donors: the University of Rochester model.
abstract: OBJECTIVE
  The donation of livers by living donors entails complex processes, both surgically and psychosocially, potentially involving risks in both domains. Thorough psychosocial evaluation is necessary to minimize those risks, yet little has been written about the donor assessment process. This article describes one such process, utilized by a transplant program in upstate New York.
  
  
  METHODS
  Donor candidates undergo multiple psychosocial interviews early in the overall transplant evaluation process. Evaluators subsequently meet as a group, along with an independent ethicist, to determine psychosocial candidacy prior to final medical/surgical clearance.
  
  
  RESULTS
  Between 2003 and 2007, 416 donor candidates initiated and/or underwent full evaluation, resulting in a 17.5% surgery and 55.5% exclusion rate among those individuals. Of those ruled out, 20.8% were for (medical or psychosocial) reasons associated with the recipient, and 8.7% were for donor-related psychosocial issues.
  
  
  CONCLUSIONS
  Given the primacy ofpsychosocial and ethical issues in living liver donor candidate evaluation, the multiple interview process, followed by team discussion and overseen by an ethicist removed from other transplant program functions, has advantages as a donor assessment model.
authors.affiliation: Department of Psychiatry, University of Rochester Medical Center, Rochester, New York 14642, USA. mark_nickels@urmc.rochester.edu
authors.forename: M W
authors.initials: MW
authors.lastname: Nickels
authors.forename: J P
authors.initials: JP
authors.lastname: Cullen
authors.forename: R A
authors.initials: RA
authors.lastname: Demme
authors.forename: M
authors.initials: M
authors.lastname: Vetter
authors.forename: R
authors.initials: R
authors.lastname: Boulay
authors.forename: R
authors.initials: R
authors.lastname: Betts
authors.forename: M
authors.initials: M
authors.lastname: McKee
authors.forename: M
authors.initials: M
authors.lastname: Orloff
authors.forename: A
authors.initials: A
authors.lastname: Bozorgzadeh
mesh_terms: D000328:Adult; D003299:Cooperative Behavior; D004608:Eligibility Determination / Q000941:ethics; D004992:Ethics, Medical; D005190:Family / Q000523:psychology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D033183:Interdisciplinary Communication; D016031:Liver Transplantation / Q000941:ethics / Q000523:psychology*; D019520:Living Donors / Q000941:ethics / Q000523:psychology*; D008297:Male; D008403:Mass Screening / Q000941:ethics / Q000523:psychology*; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology; D008875:Middle Aged; D009518:New York; D010348:Patient Care Team; D010552:Personality Assessment / Q000706:statistics & numerical data*