This article is intended to help mental health clinicians who work with kidney transplant teams enhance their understanding, abilities and skills to determine the best possible psychosocially stable living donor candidates who present for evaluation. Additionally, this article is intended to help the clinician gain a better understanding of the donor ability and willingness to give informed consent, and determine those who present for donorship which may be at high risk due to either historic or current mental health, substance use and current lifestyle issues. Finally, this article considers the rationale and goals of pretransplant psychosocial evaluation of potential kidney donors as well as the net effects on the families. The intent is to provide a clinical protocol useful in both private and public hospitals. The current protocol is currently being used at HCA: Henrico Doctors' Hospital, Virginia Transplant Center in Richmond, Virginia. Early post-transplant psychosocial problems and their management and the long-term adaptation for the donors are discussed. Additionally, ethical considerations are addressed.
Social work's potential role in preoperative evaluations was generally unheard of only 15 years ago, as it was considered the domain of direct health care professionals such as nurses and surgeons. Social workers have traditionally focused on the peri- and posttransplant phases. However, clinical social workers are playing an increasingly vital role in the care and psychosocial evaluation of potential kidney recipients and donors. Caring for and evaluating potential kidney recipients includes myriad unique clinical and personal challenges. This article's aim is to help clinicians gain a better clinical picture and assessment of people who choose to participate as kidney recipients by using a clinical interview protocol. Using this protocol with potential kidney recipients and their collaterals (family members, peer associates, clergy, and so forth) clarifies internal and external motivations and issues. Furthermore, using such a protocol can help clinicians ascertain potential barriers and obstacles that could interfere with a patient's compliance and can perhaps help clinicians deal with such obstacles in a more comprehensive manner. Finally, this article also attempts to illuminate the ethical complexities involved in choosing to be a potential kidney recipient.
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