Transcript Proposal to Modify Existing or Establish New

Proposal To Modify Existing or
Establish New Requirements for
the Psychosocial and Medical
Evaluation of all Living Donors
Living Donor Committee
Spring 2014
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
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
How the Proposal will Achieve its Goal

Standardization of the psychosocial and
medical evaluation process for all living donors
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)
Supporting Evidence
Living Donors in US by Volume and Type of Donor
Donation
Year
Kidney
Liver
Lung
Intestine
Pancreas
2005
6573
323
2
7
2
2006
6436
288
5
4
1
2007
6043
266
6
1
0
2008
5968
249
0
0
1
2009
6387
219
1
2
0
2010
6277
282
0
1
0
2011
5771
247
2
1
0
2012
5619
246
2
0
0
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
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-1antitrypsinphenotypes and untype-able phenotypes
Expected donor remnant volume less than 30% of
native liver volume
Prior living liver donor
What Members will Need to Do

Living donor recovery centers must follow new
policies for the psychosocial and medical
evaluation of living donors
Questions?

Christie Thomas, M.D.
Committee Chair
[email protected]

Name
Region # Representative
email address

Lee Bolton
Committee Liaison
[email protected]