Mental health assessment of altruistic non-directed kidney donors: An EAPM consensus statement

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Highlights

  • The practice of non-directed or altruistic kidney donation varies widely between countries.

  • The need for some form of mental health assessment of potential donors is well recognised, but again practice varies widely.

  • This paper reports an attempt by international authors to establish consensus about the approach to donor assessments.

  • It makes recommendations about the timing, content, process and outcomes of the assessments.

  • The paper also proposes a minimum data set to allow comparisons between centres and nations.

Section snippets

Background

The number of living kidney donations is increasing in many countries, in response to increasing demand, lengthening waiting lists for transplants from deceased donors, and, in some areas, cultural or religious resistance to deceased donation. In most such donations the donor and recipient are related genetically or emotionally, but there are various routes by which a donor may give a kidney to a recipient who is a stranger. The practice of paired, pooled or chained donation - in which a

Method

A first step toward standardization was taken by the UK & Ireland Transplant Psychiatry & Psychology group who met in March 2015 in London and proposed a national standard for mental health evaluation of the subset of living kidney donors whose donations are altruistic or non-directed.

This was used as the basis for a consensus guidance workshop convened in Nuremberg, Germany in July 2015, in conjunction with the annual meeting of the European Association of Psychosomatic Medicine. Members of

Recommendations for mental health assessment of altruistic non-directed kidney donors

  • 1.

    Which potential donors should be referred?

  • Recommendations:

    • There is clear, emphatic consensus among mental health clinicians working in the field that ALL potential altruistic donors, directed and non-directed should be referred for mental health assessment.

  • 2.

    Who should undertake assessments?

Transplant centers' access to mental health specialists varies widely and typically fall under one of the following categories: a) embedded mental health clinicians (psychiatrists, psychologists, nurse

Discussion

This guidance is offered as a pragmatic consensus statement by practitioners in the field of transplant psychiatry and psychology, in an area where the evidence base is scanty and practice varies widely. The process was unsystematised, and the participants largely self-selected: nonetheless they represent different centers in a variety of nations, including some which do not yet undertake altruistic donation. It is hoped that the guidance will be of practical value to practitioners and

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