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Copyright 2014 American Nephrology Nurses' Association
Robbins, K.C. (2014). The independent living donor advocate: An essential role for living kidney donation. Nephrology Nursing Journal, 41(6), 569-573, 586.
Prior to 2007, living kidney donors who donated a kidney to a person with chronic kidney disease were screened, educated, and cared for by the same healthcare team caring for the recipient of the transplant. The independent living donor advocate or advocate team was created out of the need to ensure that the rights of the person donating a kidney are protected, respected, and maintained. Transplant programs must now have an advocate or advocate team who is separate from the recipient healthcare team to provide objective support for the donor, without regard for the recipient, and avoid any perception of a conflict of interest between the donor and recipient.
Key Words: Living kidney donors, transplant, conflict of interest, advocate.
Goal
Discuss the benefits of a living kidney donor advocate or advocate team to support donors for living donor transplants.
Objectives
1. Describe the former practice of screening and preparing potential living kidney donors prior to the implementation of the requirement for an independent living donor advocate or advocate team.
2. Explain the role of the independent living donor advocate or advocate team.
3. Describe a medical "out" or medical "alibi," and when it can be exercised by the living donor.
The first successful living donor transplant was performed in 1954 by Dr. Joseph E. Murray and colleagues at Peter Bent Brigham Hospital (now Brigham and Women's Hospital) in Boston, Massachusetts. The transplant was between 23-year-old identical twins, and the recipient enjoyed an active life for 8 years before dying from causes unrelated to the transplant. His donor lived into his '70s, and four days before his death, celebrated 56 years of life after his historic kidney donation (Transplant Living, 2014a). Thousands of transplants have been performed in the last 60 years, and while some things have not changed, many aspects of organ donation and transplantation have.
For many years, the same team that provided care for the recipient also oversaw the care of the living donor: performing the evaluation, counseling and education during hospitalization, and the follow-up care. The question arose as to whether the same team...