Proposal To Modify Existing or Establish New Requirements for the Psychosocial and Medical Evaluation of all Living Donors Living Donor Committee Spring 2014

 OPTN policy has inconsistent requirements for psychosocial and medical evaluation of living donors  Kidney donor recovery hospitals must follow OPTN policies  Liver donor recovery hospitals must develop and follow center-specific protocols  Hospitals performing living lung, intestine or pancreas donor recovery are not required to follow OPTN policy or develop and follow center-specific protocols The Problem

 Establish standardized psychosocial and medical evaluation requirements for all types of living donors that mirror existing requirements for living kidney donors  Improve the medical evaluation process for all future living donors Goal of the Proposal

 Standardization of the psychosocial and medical evaluation process for all living donors How the Proposal will Achieve its Goal

Proposed requirements are based on recommendations from a Joint Societies Steering Committee Committee representation from: American Society of Transplantation (AST); American Society of Transplant Surgeons (ASTS); North American Transplant Coordinators Organization (NATCO) Additional Background

Donation Year KidneyLiverLungIntestinePancreas Supporting Evidence Living Donors in US by Volume and Type of Donor

 DTAC recommended minor changes to the required infectious disease testing  All references to “potential living donor” would be changed to read “living donor”  The majority of existing psychosocial and medical evaluation requirements for living kidney donors would be extended to all categories of living donors  No new requirements for living kidney donors Proposal Summary

 New living liver donor medical evaluation requirements are provided in Table 14-8  New living liver donors exclusion criteria include: HCV RNA positive, HBsAg positive  Donors with ZZ, Z-null, null-null and S-null alpha-1- antitrypsinphenotypes and untype-able phenotypes  Expected donor remnant volume less than 30% of native liver volume  Prior living liver donor Proposal Summary

 Living donor recovery centers must follow new policies for the psychosocial and medical evaluation of living donors What Members will Need to Do

 Christie Thomas, M.D. Committee Chair  Name Region # Representative address  Lee Bolton Committee Liaison Questions?