LIVING ORGAN DONORS
September 16, 2003
FWD: SHOULD A
PATIENT BE TOLD THAT HEPATITIS C CAN RETURN AND INFECT THE
Several organizations have made recommendations aimed at
protecting living organ donors.
The United Network for Organ Sharing, which runs the nation's
transplant network under a government contract, agreed at
its June meeting:
Hospitals that want to perform living donor transplants
should meet minimum criteria, such as having surgeons with
significant experience. Other hospitals may still perform
the transplants, but lack of UNOS approval could be a red
flag to patients and/or insurance companies.
The questionnaire used to track the well-being of living
donors will be updated. But many donors are never interviewed,
and the network's action will not change that.
Potential living donors "should have a psychosocial evaluation."
The network rejected a proposal to make this mandatory.
The network will develop educational materials for potential
living donors explaining the risks and the donation process.
The New York State Transplant Council Committee on Quality
Improvement issued a series of recommendations, now under
review by the state Health Department, after a 35-year-old
donor died in 2002:
Hospitals performing living donor transplants would be
required to have donor advocate teams with power to veto
any donor candidates. Hospital transplant programs would
have to have minimum staffing ratios and experienced surgeons.
Only patients age 55 and under, who have suffered at
least one complication from their disease, would be eligible
to get livers from living donors.
The state would create a donor registry with reporting
of donor short- and long-term outcomes mandatory.
Hospital could only take organs from people who have
a "vital emotional relationship" to the recipient, thus
nixing "good Samaritan" donations from strangers.
The federal Advisory Committee on Transplantation made several
recommendations to the secretary of the Department of Health
and Human Services, and they have been forwarded to UNOS
or other agencies for consideration:
The government should create a standardized informed
consent document to make sure all potential donors understand
All hospitals must have independent donor advocates.
HHS should establish a database of health outcomes of
all live donors.
An independent resource center should be considered to
assist living donors and their families.
The organ allocation system should be changed to give
all living donors preference should they someday need an
organ transplant. Current policy only gives preference to
kidney donors who later need a kidney.
Hospitals that take organs from living donors should
have to meet certain standards.