The donor advocacy team: a risk management program for living organ, tissue, and cell transplant donors

Background and Purpose Although the incidence of living donor death is low in Japan, statistics show one living liver donor death in more than 7000 living liver transplants. Thus, medical transplant personnel must recognize that the death of a living organ or tissue transplant donor can occur and develop an appropriate risk management program. Methods and results We describe how Nagasaki University Hospital established and implemented a Donor Advocacy Team (DAT) program: a risk management program for initiation in the event of serious, persistent, or fatal impairment of an organ, tissue, or cell transplantation from a living donor. Discussion The purposes of the DAT program are as follows: To disclose official information without delay. To provide physical and psychological care to the patient experiencing impairment and their family. To provide psychological care to the medical staff in charge of the transplant. To standardize the responses of the diagnosis and treatment department staff and other hospital staff. To minimize the damage that the whole medical transplantation system may suffer and leverage the occurrence for improvement. To address (1) and (5), actions, such as reporting and responses to the government, mass media, transplant-related societies, and organ transplant networks, have been established to ensure implementation.