Living donor program crisis management plans: Current landscape and talking point recommendations

Area of Science:

• Transplantation Surgery
• Organ Donation
• Medical Crisis Management

Background:

• Living organ donation, while generally safe, carries an unavoidable, albeit extremely low, risk of perioperative mortality.
• Anticipation of poor donor outcomes can cause anxiety and unpreparedness among healthcare professionals and transplant programs.
• Systemic preparedness for living donor deaths is crucial for maintaining program integrity and supporting affected individuals.

Purpose of the Study:

• To assess the experiences and systemic preparedness of US transplant programs regarding living donor deaths.
• To identify the level of concern among transplant surgeons about potential living donor mortality.
• To determine the availability of written crisis management plans within transplant institutions.

Main Methods:

• A national survey was distributed to US transplant surgeons.
• Respondents represented 71 kidney and 16 liver donor programs (87 unique programs).
• The survey gathered data on experiences, concerns, and preparedness for living donor deaths.

Main Results:

• Perioperative deaths in living donors were infrequent, aligning with expectations.
• A significant majority of respondents (64%) expressed moderate to extreme concern about potential living donor deaths.
• Only 33% of surveyed programs reported having a written crisis management plan, with 63% indicating a need for guidance.

Conclusions:

• A notable gap exists in written crisis management plans for living donor deaths across US transplant programs.
• Transplant programs frequently express concern regarding living donor mortality, underscoring the need for structured preparedness.
• The American Society of Transplantation Live Donor Community of Practice has developed resources to aid programs in creating essential crisis management plans.