title: The Psychosocial and Independent Living Donor Advocate Evaluation and Post-surgery Care of Living Donors.
abstract: Solid organ transplantation as a treatment for end stage organ failure has been an accepted treatment option for decades. Despite advances in medicine and technology, and increased awareness of organ donation and transplantation, the gap between supply and demand continues to widen. Living donation has been an option that has increased the number of transplants despite the continued shortage of deceased organs. In the early 2000s live donor transplantation reached an all-time high in the United States. As a result, a consensus meeting was convened in 2000 to increase the oversight of living donor transplantation. Both the Centers for Medicare and Medicaid Services and the United Network for Organ Sharing developed regulations that transplant programs performing live donor transplantation. These regulations and guidelines involve the education, evaluation, informed consent process and living donor follow-up care. Two areas in which had significant changes included the psychosocial and the independent living donor advocate (ILDA) evaluation. The purpose of this paper was to outline the current regulations and guidelines associated with the psychosocial and ILDA evaluation as well as provide further recommendations for the administration of a high quality evaluation of living donors. The goals and timing of the evaluation and education of donors; qualifications of the health care providers performing the evaluation; components of the evaluation; education provided to donors; documentation of the evaluation; participation in the selection committee meeting; post-decline and post-donation care of donors is described. Caveats including the paired donor exchange programs and non-directed and directed donation are also considered.
authors: Recanati Miller Transplant Institute, The Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1104, New York, NY, 10029, USA. dianne.lapointerudow@mountsinai.org.
authors: Dianne LaPointe
authors: DL
authors: Rudow
authors: Department of Trauma Services, Beaumont Health System, 3601 West 13 Mile Rd., Royal Oak, MI, 4807, USA. kathleen.swartz@beautmont.edu.
authors: Kathleen
authors: K
authors: Swartz
authors: Division of Hepatobiliary and Pancreatic Surgery, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA. steeljl@upmc.edu.
authors: Chelsea
authors: C
authors: Phillips
authors: Department of Collaborative Care Management, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA, 15213, USA. hollenbergerjc@upmc.edu.
authors: Jennifer
authors: J
authors: Hollenberger
authors: Department of Collaborative Care Management, University of Pittsburgh Medical Center, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA. taylor.smith4@va.gov.
authors: Taylor
authors: T
authors: Smith
authors: Department of Surgery, Psychiatry and Psychology, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA. steeljl@upmc.edu.
authors: Jennifer L
authors: JL
authors: Steel
mesh_terms: D006801:Humans; D057187:Independent Living / Q000523:psychology*; D007258:Informed Consent / Q000523:psychology; D019520:Living Donors / Q000523:psychology*; D016377:Organ Transplantation / Q000523:psychology*; D010344:Patient Advocacy / Q000523:psychology*; D018579:Patient Selection; D014481:United States
keywords: Education; Evaluation; Independent living donor advocate; Living donor; Psychosocial evaluation; Transplantation