Abstract
An inefficient living donor candidate evaluation process can be a barrier to timely living donor transplantation and optimal donor satisfaction. In this review, we examine the inefficiencies of the living kidney donor evaluation and make recommendations to optimize this process. There is increasing awareness that the living donor evaluation process is inefficient, but little research has been done to date. The time to complete the evaluation can be several or even many months. Avoidable delays can lead to dialysis initiation for pre-emptive transplant candidates, lengthen dialysis time for those patients on dialysis, and reduce donor satisfaction. Opportunities to improve efficiency include the choice, timing, sequencing of evaluation tests, procedures and consults, use of navigators, and monitoring of evaluation timeliness as a quality metric. A more efficient evaluation is expected to result in better health outcomes for patients with kidney failure and incur substantial cost savings to the healthcare system.
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