Living Donor Informed Consent Checklist (Page 2 of 4) in pdf

Living Donor Informed Consent Checklist



Personal health information collected during the transplant candidate’s evaluation, which is

confidential and protected under privacy law

9. Health information obtained during the living donor evaluation is subject to the same regulations as all

medical records and could reveal conditions that must be reported to local, state, or federal public health

authorities.

10. The recovery hospital is required to:

a. Report living donor follow-up information, at the time intervals specified in Policy 18.5: Living Donor

Data Submission Requirements

b. Have the donor commit to post donation follow-up testing coordinated by the recovery hospital.

11. Any infectious disease or malignancy that is pertinent to acute recipient care discovered during the donor’s

first two years of follow-up care:

a. May need to be reported to local, state or federal public health authorities

b. Will be disclosed to their recipient’s transplant hospital

c. Will be reported through the OPTN Improving Patient Safety Portal

12. A living donor must undergo a medical evaluation according to Policy 14.4: Medical Evaluation

Requirements for Living Donors and a psychosocial evaluation as required by Policy 14.1: Psychosocial

Evaluation Requirements for Living Donors.

13. The hospital may refuse the living donor. In such cases, the recovery hospital must inform the living donor

that a different recovery hospital may evaluate the living donor using different selection criteria

14. The following are inherent risks associated with evaluation for living donation:

a. Allergic reactions to contrast

b. Discovery of reportable infections

c. Discovery of serious medical conditions

d. Discovery of adverse genetic findings unknown to the living donor

e. Discovery of certain abnormalities that will require more testing at the living donor’s expense or create

the need for unexpected decisions on the part of the transplant team

15. There are surgical, medical, psychosocial, and financial risks associated with living donation, which may

be temporary or permanent and include, but are not limited to, all of the following:

a. Potential medical or surgical risks:

i. Death

ii. Scars, hernia, wound infection, blood clots, pneumonia, nerve injury, pain, fatigue, and other

consequences typical of any surgical procedure

iii. Abdominal symptoms such as bloating, nausea, and developing bowel obstruction

iv. That the morbidity and mortality of the living donor may be impacted by age, obesity,

hypertension, or other donor-specific pre-existing conditions

b. Potential psychosocial risks:

i. Problems with body image

ii. Post-surgery depression or anxiety

iii. Feelings of emotional distress or grief if the transplant recipient experiences any recurrent

disease or if the transplant recipient dies

iv. Changes to the living donor’s lifestyle from donation

c. Potential financial impacts:

i. Personal expenses of travel, housing, child care costs, and lost wages related to donation might

not be reimbursed; however, resources might be available to defray some donation-related

costs

ii. Need for life-long follow up at the living donor’s expense

iii. Loss of employment or income

iv. Negative impact on the ability to obtain future employment

v. Negative impact on the ability to obtain, maintain, or afford health insurance, disability

insurance, and life insurance

vi. Future health problems experienced by living donors following donation may not be covered by

the recipient’s insurance

Page 2 of 4

Last Updated: 06/01/2017

Living Donor Informed Consent Checklist Page 2

Related Articles

Related forms

Related Categories