Thursday, November 15, 2012

Donor evaluation and follow ups- a new ruling!


How do most kidney donor's do long term? Studies have shown that donors actually do better than normal population. Certain risks have been identified. Racial disparities also have been found. A recent New York Times posting discusses the advent of the donor follow up structure to me more strict. A better safe guard system, making sure the risks of donation are discussed with all donors and appropriate follow up for certain period of time were things that were discussed. Although long-term data on the donor evaluation is scarce, few living kidney donors are thought to suffer lasting physical or psychological effects. .The Organ Procurement Transplant Network/United Network for Organ Sharing (OPTN/UNOS) has increased the amount of data collected before and after donation and increased the duration of donor follow-up to 2 years, yet there is evidence that reporting is incomplete. A recent article from the Mt Sinai transplant center argued that the US government must provide funding to support a donor follow-up registry that can allow for meaningful and valid conclusions on how we are doing as a community for our donors. Based on the new policy discussed in the NY times article

1.       By 2015, transplant programs will have to report thorough clinical information on at least 80 percent of donors and lab results on at least 70 percent. The requirements phase in at lower levels for the next two years.Dr. Stuart M. Currently 9 of 10 hospitals would currently not meet the new requirement.
2.       The medical and psychological screenings that hospitals must be conducted for potential donors. ( this is usually done internally at most centers although may not be uniform)
3.       The new policies also require that hospitals appoint an independent advocate to counsel and represent donors, and that donors receive detailed information in advance about medical, psychological and financial risks. ( Donor Nephrologists and teams usually have separate meetings from the recipient evaluations and this is likely done at most centers but probably not standardized)
Perhaps these regulations and rules will make the process safer and better for our donors. 

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