The live donor assessment tool: a psychosocial assessment tool for live organ donors.

Background: Psychosocial evaluation is an important part of the live organ donor evaluation process, yet it is not standardized across institutions, and although tools exist for the psychosocial evaluation of organ recipients, none exist to assess donors.

Objective: We set out to develop a semistructured psychosocial evaluation tool (the Live Donor Assessment Tool, LDAT) to assess potential live organ donors and to conduct preliminary analyses of the tool's reliability and validity.

Methods: Review of the literature on the psychosocial variables associated with treatment adherence, quality of life, live organ donation outcome, and resilience, as well as review of the procedures for psychosocial evaluation at our center and other centers around the country, identified 9 domains to address; these domains were distilled into several items each, in collaboration with colleagues at transplant centers across the country, for a total of 29 items.

The role of the independent donor advocacy team in the case of a declined living donor candidate.

Many controversies arise when living donor candidates present themselves for consideration as donors for urgent liver transplants. Nonparent living donors for urgent pediatric transplant recipients are a unique donor candidate population with specific considerations that need to be acknowledged and addressed by the independent donor advocacy team. Such a team educates about donation, identifies potential contraindications, examines the distant relationships between donor and recipient, and considers ethical issues about the ability to make an informed decision in an urgent situation.