Standardized evaluation consent forms for living liver donors needed

Call for liver transplant centers to incorporate an alibi in donor documents

2014-03-13

(Press-News.org) New research reveals that 57% of liver transplant centers use living donor evaluation consent forms that include all the elements required by the Centers for Medicare and Medicaid Services (CMS) and 78% of centers addressed two-third or more of the items recommended by the Organ Procurement and Transplant Network (OPTN). The study published in Liver Transplantation, a journal of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, reviewed the living donor evaluation consent forms from 26 of the 37 transplant centers that evaluate living liver donors in the U.S.

In addition, the Yale researchers found that only 17% of transplant centers' evaluation consent forms offer an alibi to potential donors. An alibi is a statement of unsuitability for donation that a transplant center can provide to an individual who decides that he or she does not want to donate. The OPTN guidelines for living liver donors endorse the use of alibis to help ensure that individuals are free from undue pressure to donate.

The first successful U.S. living liver donor transplant was performed in 1989. Living liver donors account for 4% of the 7000 transplants occurring each year in the country. In contrast, approximately one-third of transplanted kidneys come from living donors. Prior studies suggest the relative infrequency of living liver donation is due to the complexity of the procedure and greater mortality and morbidity risk to living liver donors.

"Our study is the first to systematically examine written informed consent for living liver donor evaluation donation in the U.S.," explains lead author Dr. Carrie Thiessen from Yale School of Medicine in New Haven, Conn. "Our findings reinforce the need for standardization of living liver donor liver evaluation consent forms. We also recommend that written offers of alibis be included in consent forms to help preserve donor autonomy. Evaluation consent forms should explicitly address whether a transplant center will or will not disclose a potential donor's decision to decline donation, reason for opting out, and health details following withdrawal."

Dr. Thiessen concludes, "We hope that our study results will inform the current OPTN and UNOS efforts to revise national living liver donor policy and will aid transplant centers in improving the clarity of their living donor consent documents."

Dr. David Mulligan contributing author and Chair of the UNOS Liver & Intestine Committee agrees, "This study emphasizes the importance of building transparency in the living liver donor programs by standardizing the consent forms. The goal is to encourage more living donors to donate and that will only happen if donors fully understand the process for donating, the risks involved, and the course of recovery. Ultimately, the transplant community wants to make it as safe as possible for living donors who are providing a life-saving piece of their liver to patients with liver failure."

INFORMATION: This study is published in Liver Transplantation. Media wishing to receive a PDF of the article may contact sciencenewsroom@wiley.com

Full citation: "Written Informed Consent for Living Liver Donor Evaluation: Compliance with CMS & OPTN Guidelines and Alibi Offers." Carrie Thiessen, Yunsoo A. Kim, Peter S. Yoo, Manuel Rodriguez-Davalos, David Mulligan and Sanjay Kulkarni. Liver Transplantation; (DOI: 10.1002/lt.23822) Published Online: February 24, 2014.

URL: http://doi.wiley.com/10.1022/lt.23822

Author Contact: Media wishing to speak with Dr. Sanjay Kulkarni, the paper's senior author, may contact the Yale-New Haven Hospital Transplant Center at 203-785-2565

About the Journal Liver Transplantation is published by Wiley on behalf of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. Since the first application of liver transplantation in a clinical situation was reported more than twenty years ago, there has been a great deal of growth in this field and more is anticipated. As an official publication of the AASLD and the ILTS, Liver Transplantation delivers current, peer-reviewed articles on surgical techniques, clinical investigations and drug research — the information necessary to keep abreast of this evolving specialty. For more information, please visit http://wileyonlinelibrary.com/journal/lt.

About Wiley Wiley is a global provider of content-enabled solutions that improve outcomes in research, education, and professional practice. Our core businesses produce scientific, technical, medical, and scholarly journals, reference works, books, database services, and advertising; professional books, subscription products, certification and training services and online applications; and education content and services including integrated online teaching and learning resources for undergraduate and graduate students and lifelong learners.

Founded in 1807, John Wiley & Sons, Inc. (NYSE: JWa, JWb), has been a valued source of information and understanding for more than 200 years, helping people around the world meet their needs and fulfill their aspirations. Wiley and its acquired companies have published the works of more than 450 Nobel laureates in all categories: Literature, Economics, Physiology or Medicine, Physics, Chemistry, and Peace. Wiley's global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company's website can be accessed at http://www.wiley.com.

ELSE PRESS RELEASES FROM THIS DATE:

Tropical grassy ecosystems under threat, scientists warn

2014-03-13

Scientists at the University of Liverpool have found that tropical grassy areas, which play a critical role in the world's ecology, are under threat as a result of ineffective management. According to research, published in Trends in Ecology and Evolution, they are often misclassified and this leads to degradation of the land which has a detrimental effect on the plants and animals that are indigenous to these areas. Tropical grassy areas cover a greater area than tropical rain forests, support about one fifth of the world's population and are critically important ...

Gene variants protect against relapse after treatment for hepatitis C

2014-03-13

More than 100 million humans around the world are infected with hepatitis C virus. The infection gives rise to chronic liver inflammation, which may result in reduced liver function, liver cirrhosis and liver cancer. Even though anti-viral medications often efficiently eliminate the virus, the infection recurs in approximately one fifth of the patients. Prevents incorporation in DNA Martin Lagging and co-workers at the Sahlgrenska Academy have studied an enzyme called inosine trifosfatas (ITPase), which normally prevents the incorporation of defective building blocks ...

Study: Response to emotional stress may be linked to some women's heart artery dysfunction

2014-03-13

LOS ANGELES (March 12, 2014) – Researchers at the Barbra Streisand Women's Heart Center at the Cedars-Sinai Heart Institute have found that emotional stressors – such as those provoking anger – may cause changes in the nervous system that controls heart rate and trigger a type of coronary artery dysfunction that occurs more frequently in women than men. They will describe their findings at the American Psychosomatic Society's annual meeting on March 13 in San Francisco. In men with coronary artery disease, the large arteries feeding the heart tend to become clogged ...

Most of the sand in Alberta's oilsands came from eastern North America, study shows

2014-03-13

They're called the Alberta oilsands but most of the sand actually came from the Appalachian region on the eastern side of the North American continent, a new University of Calgary-led study shows. The oilsands also include sand from the Canadian Shield in northern and east-central Canada and from the Canadian Rockies in western Canada, the study says. This study is the first to determine the age of individual sediment grains in the oilsands and assess their origin. "The oilsands are looked at as a Western asset," says study lead author Christine Benyon, who is just ...

What happened when? How the brain stores memories by time

2014-03-13

VIDEO: An area of the brain called the hippocampus stores memories based on their sequence in time, instead of by their content, UC Davis researchers have found. The discovery has implications... Click here for more information. Before I left the house this morning, I let the cat out and started the dishwasher. Or was that yesterday? Very often, our memories must distinguish not just what happened and where, but when an event occurred — and what came before and after. New research ...

A brain signal for psychosis risk

2014-03-13

Philadelphia, PA, March 13, 2014 – Only one third of individuals identified as being at clinical high risk for psychosis actually convert to a psychotic disorder within a 3 year follow-up period. This risk assessment is based on the presence of sub-threshold psychotic-like symptoms. Thus, clinical symptom criteria alone do not predict future psychosis risk with sufficient accuracy to justify aggressive early intervention, especially with medications such as antipsychotics that produce significant side effects. Accordingly, there is a strong imperative to develop biomarkers ...

Exchange rate behaves like particles in a molecular fluid

2014-03-13

When scientists observe minute particles like nanoparticles or bacteria in fluid under a microscope, they don't see a motionless image. What they do see are particles making the tiniest irregular twitches not unlike the nervous ups-and-downs of market prices and exchange rates. These two forms of random twitching – microparticles in fluid and price developments on the financial market – are not just similar at first sight as a Japanese-Swiss team has now demonstrated. The underlying mechanism is the same too. Brownian motion, the name given by scientists to the microtwitching ...

Performing cardio- and resistance training during the same session: Does the order matter?

2014-03-13

Although the remarkable benefits of combined training have been clarified by numerous investigations, fitness enthusiasts struggle with the same question: Does the order of cardio- and resistance training influence the effectiveness of a training program? This question has now been the focus of a series of investigations in the Department of Biology of Physical Activity at the University of Jyväskylä. The international research group led by Professor Keijo Häkkinen and coordinated by PhD student Moritz Schumann has recruited a total of almost 200 recreationally active ...

Compassionate Allowances Program yields faster SSDI benefit decisions

2014-03-13

Compassionate Allowances Program yields faster SSDI benefit decisions Article provided by Smolich & Smolich Visit us at http://www.smolichlaw.com An oft-overlooked option for applicants seeking Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits could make the process both less tedious and quicker. The Compassionate Allowances Program (CAP) essentially fast-tracks disability benefits applications for people whose medical conditions are so severe they objectively meet the Social Security Administration (SSA)'s definition ...

Immigrants accused of crimes often held for months and face deportation

2014-03-13

Immigrants accused of crimes often held for months and face deportation Article provided by Law Offices of Mark A. Davis Visit us at http://www.madlawonline.com For any individual, getting charged with a crime can be a serious matter. If you are an immigrant to this country, the stakes are particularly high. Even a relatively minor offense can affect the status of your visa, can make you ineligible for citizenship or permanent residency, and, in some cases, can lead to deportation. According to ICE data, last year 82 percent of the agency's deportations concerning ...

LAST 30 PRESS RELEASES:

AACR: Five MD Anderson researchers honored with 2025 Scientific Achievement Awards

How not to form a state: Research reveals how imbalanced social-ecological acceleration led to collapse in early medieval Europe

DDT residues persist in trout in some Canadian lakes 70 years after insecticide treatment, often at levels ten times that recommended as safe for the wildlife which consumes the fish