title: A national survey of independent living donor advocates: the need for practice guidelines.
abstract: In 2000, representatives of the transplant community convened for a meeting on living donation in an effort to provide recommendations to promote the welfare of living donors. One key recommendation included in the consensus statement was that all transplant centers which have performed living donor surgeries have an independent living donor advocate (ILDA) "whose only focus is on the best interest of the donor." The aims of this study were to begin to understand the sociodemographic characteristics, selection and training, and clinical practices of ILDAs. All US transplant centers performing living donor surgeries were contacted to identify the ILDA at their center. One hundred and twenty ILDAs completed an anonymous survey. Results indicated considerable variability with regard to the sociodemographic characteristics of ILDAs, how the ILDA was selected and trained, and the ILDAs' clinical practices, particularly ethical challenges encountered by ILDAs. The variability observed may result in differential selection of donors and could have a potential negative impact on the lives of both donors and transplant candidates. The variability in the background, training, and practice of ILDAs suggests the need for strategies, such as practice guidelines, to standardize the interaction between ILDAs and living donors.
authors.affiliation: Department of Surgery and Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. steeljl@upmc.edu
authors.forename: J
authors.initials: J
authors.lastname: Steel
authors.forename: A
authors.initials: A
authors.lastname: Dunlavy
authors.forename: M
authors.initials: M
authors.lastname: Friday
authors.forename: K
authors.initials: K
authors.lastname: Kingsley
authors.forename: D
authors.initials: D
authors.lastname: Brower
authors.forename: M
authors.initials: M
authors.lastname: Unruh
authors.forename: H
authors.initials: H
authors.lastname: Tan
authors.forename: R
authors.initials: R
authors.lastname: Shapiro
authors.forename: M
authors.initials: M
authors.lastname: Peltz
authors.forename: M
authors.initials: M
authors.lastname: Hardoby
authors.forename: C
authors.initials: C
authors.lastname: McCloskey
authors.forename: M
authors.initials: M
authors.lastname: Sturdevant
authors.forename: A
authors.initials: A
authors.lastname: Humar
mesh_terms: D000328:Adult; D000368:Aged; D003625:Data Collection; D005260:Female; D006801:Humans; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010344:Patient Advocacy; D017410:Practice Guidelines as Topic