What Happens After Remote Living Kidney Donor Evaluation
After completing evaluation at a remote center, the donor's case and all evaluation materials must be transferred to the transplant center where the actual donor surgery will be performed for final psychosocial evaluation, acceptance decision, and surgical planning. 1
Transfer to Transplant Center
The evaluation and final acceptance decision must occur at the center where donor surgery will take place, with a specific exception only for paired donation programs where evaluation may occur at the donor's local center before entering the matching system. 1
Key Steps Following Remote Evaluation:
Mandatory On-Site Psychosocial Evaluation
- A detailed on-site psychosocial evaluation is mandatory for all prospective unrelated donors at the transplant center. 1
- This evaluation must be conducted by an independent donor team entirely separate from the transplant candidate's team. 1
- For programs lacking resources for a separate donor team, an external consultant not affiliated with the transplant team must conduct the evaluation to serve as the donor advocate. 1
Two-Session Interview Process
- The first session addresses all psychosocial components and should be conducted by a clinical social worker, nurse specialist, or similarly trained allied health professional. 1
- The second session involves more extensive evaluation of any areas of concern, along with further psychological examination, conducted by a psychologist or psychiatrist. 1
- The donor should initially be interviewed alone, with an additional interview or telephone conversation including the donor's significant other also recommended. 1
Mandatory Cooling-Off Period
A donor "cooling off" period after the Phase II evaluation is required to ensure the decision to donate has been adequately considered. 1
- The duration should be at the discretion of the donor team or independent evaluator but should generally be at least 2 weeks. 1
- This period allows the prospective donor time to reflect on the decision without pressure. 1
Critical Timing Consideration
The psychosocial evaluation should be conducted early during the complete medical evaluation so that invasive medical examinations can be avoided if clear psychosocial contraindications become apparent. 1
Common Pitfall to Avoid
Do not proceed with invasive testing at the remote center before psychosocial clearance at the transplant center. The transplant program must ensure coordination between the remote evaluation site and the transplant center to avoid unnecessary invasive procedures if psychosocial contraindications exist. 1