Donating and receiving organs quite often involves family members partnering toward a single medical goal. Despite sharing the transplant experience, keeping personal medical information private for donor and recipient is nevertheless essential.
A 21-year-old woman contacted a hospital transplant program and expressed her desire to donate a kidney to her uncle, with whom she and her mother lived. An extensive medical workup of the young woman included a psychological evaluation and an explanation by a registered nurse of the details of the "living donor consent form" written on the hospital's letterhead.
That lengthy consent form included two passages dealing with how personal medical information would be treated. In one section, the consent stated: "All information about the donor and recipient will be kept confidential unless there is written permission from the donor or recipient that information be provided."
In a section that followed, the consent form offered the assurance that "information about your medical evaluation, diagnostic test results [sic] will not be discussed with the potential kidney transplant recipient unless you give written permission." Signing on behalf of the hospital was a registered nurse coordinator assigned specifically to the donor. (Another nurse coordinator was assigned to the uncle, per protocol.)
Medscape Editor's Key Notes:
• When patients are family members in the same home, remain extra vigilant about keeping each patient's information private.
• Develop a protocol for disclosing information to cohabitating patients.
• Ensure that all team members understand the boundaries.
As part of her workup over the months leading up to the donation, the young woman underwent regular pregnancy tests. During the course of her evaluation, she had two negative hCG blood tests: one shortly before signing the donor consent form and another 1 month before the scheduled transplant.
During a preoperative consult 1 week before the scheduled surgery, Dr GS, the general surgeon for the transplant, noted that the donor's last menstrual period was nearly 1 month prior. He noted his impression that the young woman was an "excellent kidney donor." On that day, the donor underwent another hCG screening and a blood cross-match.
© 2021 Cooperative of American Physicians, Inc.
This case comes from Medicine on Trial, originally published by Cooperative of American Physicians, Inc., to provide risk management lessons from litigated case histories.