Detailed Abstract
[E-poster - Liver (Others (ERAS, Education etc.))]
[EP 028] Enhancing Living Donor Care: Initial Outcomes of the Independent Advocate for the Well-being of Living Donor (IAWLD) Role
Veysel UMMAN1
1Department of Liver Transplantation and Hepatobiliary Surgery, Izmir University of Economics Faculty of Medicine MedicalPoint Hospital, Turkey
Background : Liver transplantation, widely performed globally, boasts high success rates. Living donor liver transplants (LDLT) reduce waiting times, have shorter ischemia times, and offer higher-quality organs. However, given the complexity of donor hepatectomy, LDLT in Europe and the USA focuses on protecting donor rights, standardizing medical and psychological evaluations of donors, and minimizing complications and potential donor mortality.
Methods : Turkiye ranks among the top three globally and leads Europe in LDLT execution, yet there is a lack of national standardization in LDLT protocols, including follow-up, reporting, donor and recipient criteria, and regular audits by health authorities. A working group with the Ministry of Health was formed to revise the regulations for LDLT operations based on practices in the USA and Europe. The role of IAWLD has been established; a social worker, psychologist or psychiatrist in this position is committed to informing donors and protecting their rights, and is independent of the recipient evaluation process.
Results : Between 2022 and 2023, our center interviewed 287 donor candidates following the IALDW implementation. Of these, 51 were disqualified after initial interviews, mainly due to substance and alcohol use, reluctance, involuntary participation, or familial pressure. Over half requested medical excuses for withdrawal. Notably, these candidates were excluded before complete evaluations like psychiatric consultations or medical tests, including lab results and tomography.
Conclusions : LDLT is vital due to the shortage of deceased donors, particularly in Asian cultures, where traditions and religious beliefs play a significant role. Often, donors commit to donating to their loved ones before fully understanding the procedure, leading to uninformed choices, decision ambivalence, and potential pressure once the evaluation begins. Addressing the increasing evidence of serious mental health issues in donors is essential for their wellbeing. The IAWLD ensures donors are aware they can confidentially withdraw from the consent and evaluation process at any time.
Methods : Turkiye ranks among the top three globally and leads Europe in LDLT execution, yet there is a lack of national standardization in LDLT protocols, including follow-up, reporting, donor and recipient criteria, and regular audits by health authorities. A working group with the Ministry of Health was formed to revise the regulations for LDLT operations based on practices in the USA and Europe. The role of IAWLD has been established; a social worker, psychologist or psychiatrist in this position is committed to informing donors and protecting their rights, and is independent of the recipient evaluation process.
Results : Between 2022 and 2023, our center interviewed 287 donor candidates following the IALDW implementation. Of these, 51 were disqualified after initial interviews, mainly due to substance and alcohol use, reluctance, involuntary participation, or familial pressure. Over half requested medical excuses for withdrawal. Notably, these candidates were excluded before complete evaluations like psychiatric consultations or medical tests, including lab results and tomography.
Conclusions : LDLT is vital due to the shortage of deceased donors, particularly in Asian cultures, where traditions and religious beliefs play a significant role. Often, donors commit to donating to their loved ones before fully understanding the procedure, leading to uninformed choices, decision ambivalence, and potential pressure once the evaluation begins. Addressing the increasing evidence of serious mental health issues in donors is essential for their wellbeing. The IAWLD ensures donors are aware they can confidentially withdraw from the consent and evaluation process at any time.
SESSION
E-poster
E-Session 03/21 ALL DAY