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Proposal to Standardize Psychosocial & Medical Evaluation for Living Donor Committee Spring 2014

Addressing inconsistencies in evaluation requirements for living donors to improve the process and align with kidney donation standards, based on Joint Societies Steering Committee recommendations.

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Proposal to Standardize Psychosocial & Medical Evaluation for Living Donor Committee Spring 2014

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  1. Proposal To Modify Existing or Establish New Requirements for the Psychosocial and Medical Evaluation of all Living Donors Living Donor Committee Spring 2014

  2. The Problem • OPTN policy has inconsistent requirements for psychosocial and medical evaluation of living donors • Kidney donor recovery hospitals must follow OPTN policies • Liver donor recovery hospitals must develop and follow center-specific protocols • Hospitals performing living lung, intestine or pancreas donor recovery are not required to follow OPTN policy or develop and follow center-specific protocols

  3. Goal of the Proposal • Establish standardized psychosocial and medical evaluation requirements for all types of living donors that mirror existing requirements for living kidney donors • Improve the medical evaluation process for all future living donors

  4. How the Proposal will Achieve its Goal • Standardization of the psychosocial and medical evaluation process for all living donors

  5. Additional Background • Proposed requirements are based on recommendations from a Joint Societies Steering Committee • Committee representation from: • American Society of Transplantation (AST); • American Society of Transplant Surgeons (ASTS); • North American Transplant Coordinators Organization (NATCO)

  6. Supporting EvidenceLiving Donors in US by Volume and Type of Donor

  7. Proposal Summary • DTAC recommended minor changes to the required infectious disease testing • All references to “potential living donor” would be changed to read “living donor” • The majority of existing psychosocial and medical evaluation requirements for living kidney donors would be extended to all categories of living donors • No new requirements for living kidney donors

  8. Proposal Summary • New living liver donor medical evaluation requirements are provided in Table 14-8 • New living liver donors exclusion criteria include: • HCV RNA positive, HBsAg positive • Donors with ZZ, Z-null, null-null and S-null alpha-1-antitrypsinphenotypes and untype-able phenotypes • Expected donor remnant volume less than 30% of native liver volume • Prior living liver donor

  9. What Members will Need to Do • Living donor recovery centers must follow new policies for the psychosocial and medical evaluation of living donors

  10. Questions? • Christie Thomas, M.D. Committee Chairchristie-thomas@uiowa.edu • Name Region # Representativeemail address • Lee Bolton Committee Liaisonlee.bolton@unos.org

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