Recommendations for Living Kidney Donor Follow-Up in Canada

Post-donation care is variable in Canada.

A virtual workshop including donors and health providers was conducted to advance recommendations for a new national standard of living donor follow-up. Attendees participated in facilitated breakout groups to deliberate pre-set questions on a draft care model informed by a survey of 685 previous donors. Deliberations were audio-recorded, transcribed, and imported into HyperRESEARCH software to facilitate inductive, systematic and auditable coding of the data. Final meeting recommendations were approved by attendees and then presented for consideration of endorsement by all Canadian programs.

We identified four themes: (1) Establishing a donor centric long-term follow-up plan; (2) Generating data to optimize donor outcomes; (3) Safeguarding donors and (4) Partnership to strengthen care (transplant centers enacting duty of care, setting expectations with donors for follow up, supporting a collaborative model with primary care doctors, harnessing technology, ensuring consistency, regularity, and feasibility). Post-donation care should be donor-centric, flexible and based on a strong collaboration between primary care providers and transplant programs. The new model should include a "safety net" to provide specialist care when needed, as well as donor consent for capture of long-term health outcomes in a national registry. The recommendations are endorsed by all Canadian living donor programs.

Although necessary, the provision of universal health care coverage alone is insufficient to ensure long-term donor health and inform future practice. A new national model of long-term donor follow-up informed by the lived experience of past donors and input from primary care and transplant providers was proposed.