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Living Donor Advocate Process (4.48)

Living Donor Advocate Process (4.48) - Policies, Administrative, UWHC, Department Specific, Transplant, Living Donor

4.48



POLICY & PROCEDURE
Effective Date: April 2008
Revised Date: June 2017 Title: Independent Living Donor Advocate Process Policy Number: 4.48

Page 1 of 3
I. PURPOSE

The purpose of this policy is to ensure that potential living donor candidates are provided an
independent living donor advocate (“ILDA”) to ensure that the potential living donor candidate has
been given clear and understandable information to allow them to make an informed decision and
their decision is being made without coercion or undue influence.

II. POLICY

It is the policy of the UW Transplant Program to remain compliant with the regulations set forth by
all regulatory agencies to include the Organ Procurement and Transplantation Network (OPTN) and
the United Network of Organ Sharing (UNOS), Centers for Medicare and Medicaid (CMS) Conditions
of Participation for Transplant Programs and The Joint Commission.

III. FORMS

A. Living Kidney Donor Patient Consent Form (pdf)
B. Living Liver Donor Patient Consent Form (pdf)
C. Kidney-Living Donor TX Evaluation (HFFY #3039)
D. Independent Living Donor Advocate Training

IV. PROCEDURE

A. During the evaluation, the potential living donor candidate will meet with the ILDA to assess the
following:
1. The future medical care and social support of the donor.
2. Any external pressures that impact the prospective living donor’s decision about whether
to donate, including presence of coercion, or risk of secondary gain as a motivation.
3. The patient’s understanding of his/her current medical history and its implications for
the suitability of donation, including possible long-term clinical implications of the organ
donation.
4. The patient’s understanding of the living organ donation process (donor evaluation,
donation surgery, and post-donation recovery); potential complications; and general
recovery from the surgery.
5. The patient’s understanding of psychosocial risks of donation, including financial aspects
of living donation such as future insurability, lost wages, etc.
6. The patient’s understanding of various options for the recipient other than an organ
donation from a living donor.



POLICY & PROCEDURE
Effective Date: April 2008
Revised Date: June 2017 Title: Independent Living Donor Advocate Process Policy Number: 4.48

Page 2 of 3
7. Patient understanding of voluntary nature of organ donation, including ways to finish
donor evaluation process without proceeding with donation.
8. Patient understanding of donor health records confidentiality.
9. The required areas of informed consent.
B. At the interview, the ILDA will assess the potential candidate’s learning needs, coping skills,
decision-making process, long-term expectations and commitment regarding the donation
process, including the follow-up requirements of the donor.
C. The ILDA will complete the Living Donor Advocate assessment, either on its own or as a separate
section of the Donor Social Worker assessment, and place it in the patient’s electronic medical
record.
D. The ILDA will communicate any concerns they have to the transplant team.
E. The ILDA will attend the living donor patient selection committee meeting to represent the
donor.
F. The ILDA is available to provide support to the living donor patient during their inpatient stay
following their nephrectomy or hepatectomy to answer questions and provide further
information.
G. Upon discharge, the ILDA will be available to the living donor patient via telephone for
questions, further explanations, etc., if necessary.
H. The ILDA will not be involved in recipient transplantation activities on a routine basis.

Appeals Process

1. If the ILDA is uncomfortable with the decision to accept the candidate as a donor, the ILDA
should bring this matter to the attention of the Patient Relations Manager. The Patient
Relations Manager will contact the transplant leadership team to discuss. If the parties are
unable to reach an agreement, this matter shall be deferred to the UWHC Ethics Committee
for resolution.

Qualifications, Duties, and Responsibilities

1. An ILDA will meet the qualification, duties, and responsibilities on the Independent Living
Donor Advocate Document.









POLICY & PROCEDURE
Effective Date: April 2008
Revised Date: June 2017 Title: Independent Living Donor Advocate Process Policy Number: 4.48

Page 3 of 3
V. REFERENCES

Organ Procurement Transplantation Network (OPTN) Policy 14.2

Centers for Medicare & Medicaid Services (CMS) General Requirements for Transplant Centers,
section 482.98.

VI. COORDINATION

University of Wisconsin Transplant Program

VII. REVIEWED BY

Kidney Program Manager
Living Donor Program Manager

VIII. SIGNED BY

________________________________ _________________________________
Jill Ellefson, MBA Dixon Kaufman, M.D., PhD
Organ Donation and Transplant Service Line Chair, UW Transplant Program