Living Donor Informed Consent Checklist Page 3
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4Living Donor Informed Consent Checklist
Living Kidney Donors – Additional Requirements
Provide to all living kidney donors:
Education about expected post-donation kidney function, and how chronic kidney disease (CKD) and end-
stage renal disease (ESRD) might potentially impact the living donor in the future, to include:
a. On average, living donors will have a 25-35% permanent loss of kidney function after donation.
b. Although risk of ESRD for living kidney donors does not exceed that of the general population with the
same demographic profile, risk of ESRD for living kidney donors may exceed that of healthy non-donors
with medical characteristics similar to living kidney donors.
c. Living donor risks must be interpreted in light of the known epidemiology of both CKD and ESRD. When
CKD or ESRD occurs, CKD generally develops in mid-life (40-50 years old) and ESRD generally develops
after age 60. The medical evaluation of a young living donor cannot predict lifetime risk of CKD or ESRD.
d. Living donors may be at a higher risk for CKD if they sustain damage to the remaining kidney. The
development of CKD and subsequent progression to ESRD may be faster with only one kidney.
e. Dialysis is required if the living donor develops ESRD.
Current practice is to prioritize prior living kidney donors who become kidney transplant candidates
according to Policy 8.3: Kidney Allocation Points.
Disclose to all living kidney donors:
Surgical risks may be transient or permanent and include but are not limited to:
Decreased kidney function
Acute kidney failure and the need for dialysis or kidney transplant for the living donor in the immediate
post-operative period
Disclose to all female living kidney donors:
Risks of preeclampsia or gestational hypertension are increased in pregnancies after donation
Living Liver Donors – Additional Requirements
Disclose to all living liver donors:
Surgical risks may be transient or permanent and include but are not limited to:
Acute liver failure with need for liver transplant.
Transient liver dysfunction with recovery. The potential for transient liver dysfunction depends upon the
amount of the total liver removed for donation.
Risk of red cell transfusions or other blood products.
Biliary complications, including leak or stricture that may require additional intervention.
Post-donation laboratory tests may result in abnormal or false positive results that may trigger additional
tests that have associated risks.
As part of the informed consent process, recovery hospitals must also provide transplant recipient outcome and
transplanted organ survival data to all living donors.
Outcomes Data
If the recovery hospital and the recipient hospital are the same:
Then the recovery hospital must provide the living donor with both national and that hospital’s program-
specific transplant recipient outcomes from the most recent Scientific Registry of Transplant Recipients
(SRTR) program-specific reports, including all the following information:
1. National 1-year patient and transplanted organ survival
2. The hospital’s 1-year patient and transplanted organ survival
3. Notification about all Centers for Medicare and Medicaid Services (CMS) outcome requirements not being
met by the transplant hospital
Page 3 of 4
Last Updated: 06/01/2017
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