The Evolution of the Role of the Independent Living Donor Advocate: Recommendations for Practice Guidelines

Abstract

The consensus statement on living donation recommended that all transplant centers performing living donor surgeries retain an independent living donor advocate (ILDA) “whose only focus is on the best interest of the donor.” While practice variability exists in all professions, a recent survey conducted by this team demonstrated marked variability in the way in which ILDAs practice. The recommendations that are proposed here are based on a national survey but are not exhaustive, are aspirational in intent, and are likely to evolve with time. Practice guidelines are recommended for legal and regulatory issues (e.g., state or federal laws), consumer or public benefit (e.g., improving service delivery, avoiding harm to the patient, and decreasing disparities in underserved or vulnerable populations), andprofessional guidance (e.g., new role, professional risk management issues, and advances in practice). Without such practice guidelines, donors, and indirectly the candidates, may be at increased risk for possible bias or undue harm.