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Living Liver Donor Selection & Evaluation Process (5.33)

Living Liver Donor Selection & Evaluation Process (5.33) - Policies, Administrative, UWHC, Department Specific, Transplant, Living Donor

5.33



POLICY & PROCEDURE
Effective Date: July 2013
Revised Date:
Title: Living Liver Donor Selection & Evaluation
Process
Policy Number: 5.33

Page 1 of 3
I. PURPOSE

The purpose of this policy is to provide guidelines and set standards for a multidisciplinary team to
determine the suitability and acceptance of patients as living liver donors.

II. POLICY

It is the policy of the UW Transplant program to adhere to the University of Wisconsin Hospital &
Clinics (UWHC) standards of patient care, as well as the standards determined by regulatory and
accrediting agencies, such as The Joint Commission.


III. FORMS

Guidelines for the Evaluation for Potential Live Liver Donors (pdf)
Liver Living Donor Call Flowsheet (pdf)
Procedure for Crossmatch for LIVE Donor Liver Transplants (pdf)


IV. PROCEDURE

Living donation is initiated by contact from the potential live donor to the transplant coordinator
(see Visio for initial call). The live donor coordinator is responsible for completing the initial
prescreen, establishing ABO compatibility, and discussing the risks and benefits involved (See HFFY
6839). Information gathered during the prescreen is documented in the electronic medical record.

If the pre-screen does not reveal information contradicting living donation (see policy #5.07 Living
Liver Donor Selection Criteria), the coordinator will establish/verify ABO compatibility, get initial
approval from the surgeon, and then patient will be scheduled for a clinic visit at UWHC.

The potential donor completes the donor evaluation to determine candidacy (See guidelines). If
more than one person steps forward as a potential donor, the transplant coordinator pre-screens
each potential donor and discusses with the surgeon which donor to proceed with testing. Typically
only one donor undergoes the evaluation process at a time.

As part of the evaluation process the potential donor meets with members of the donor advocate
team, including the transplant coordinator, social worker, living donor advocate, health psychologist
or psychiatrist, and internal medicine physician, as well as other members of the multidisciplinary



POLICY & PROCEDURE
Effective Date: July 2013
Revised Date:
Title: Living Liver Donor Selection & Evaluation
Process
Policy Number: 5.33

Page 2 of 3
transplant team including a transplant surgeon, hepatologist, Clinical Dietician, and others as
needed. See policy 5.39 for full description and participation of each member of the team.

Members of the Live Donor Advocate team will provide a recommendation about moving forward
with donation to the transplant team. This recommendation will address their opinion in regards to:
the donor’s ability to make an informed choice that is not coerced, the degree to which the donor
understands the risks and benefits, the donor’s overall suitability.

Once the evaluation is complete (per guidelines) the potential donor is presented to the
multidisciplinary team at the weekly liver selection meeting. A member of the live donor advocate
team will actively participate in the selection discussion, and bring forth any concerns the team has.
The patient will be accepted or denied according to the UW Transplant Department guidelines set
forth in Policy #5.07. (Living Liver Donor Selection Criteria). The decision and criteria used to make
the decision will be documented in the patient medical record. The patient will be notified of the
results from the review meeting.

If the potential donor is not a candidate, a letter to the patient and the patient’s primary physician
will be sent outlining the criteria for denial of donation and any recommended follow-up. A copy of
the correspondence is kept in the electronic UW medical record.

In all non-emergent cases, there shall be a defined period of reflection and reaffirmation of the
decision to donate subsequent to the completion of the medical work-up and the team’s final
approval.

V. REFERENCES

Report to State of New York Department of Health (February 26, 2004). New York State Committee
on Quality Improvement in Living Liver Donation.

VI. COORDINATION

University of Wisconsin Transplant Program

VII. REVIEWED BY

Transplant Service Line Policy and Procedure Committee 7/2013





POLICY & PROCEDURE
Effective Date: July 2013
Revised Date:
Title: Living Liver Donor Selection & Evaluation
Process
Policy Number: 5.33

Page 3 of 3
VIII. SIGNED BY


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