Living Donor Informed Consent Checklist Page 4

Living Donor Informed Consent Checklist

If the recovery hospital and the recipient hospital will not be the same and



the recipient hospital is known:

Then the recovery hospital must provide the living donor with both national and the recipient hospital’s

program-specific transplant recipient outcomes from the most recent SRTR program-specific reports,

including all the following information:

1. National 1-year patient and transplanted organ survival

2. The recipient hospital’s 1-year patient and transplanted organ survival

3. Notification about all CMS outcome requirements not being met by the recipient hospital

If the recovery hospital and the recipient hospital will not be the same and



the recipient hospital is not known:

Then the recovery hospital must provide the living donor with national transplant recipient outcomes from the

most recent SRTR reports, including national 1-year patient and transplanted organ survival.

Page 4 of 4

Last Updated: 06/01/2017

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