Organ Donation Consent Form

The Organ Donation Consent Form provides comprehensive informed consent documentation for living organ donors undergoing evaluation and surgical donation. This template addresses the unique medical, ethical, and psychosocial dimensions of living donation as outlined by UNOS (United Network for Organ Sharing), CMS Conditions of Participation for Transplant Centers, and the OPTN (Organ Procurement and Transplantation Network) policies. The form covers the type of donation being considered (living kidney donation, living liver lobe donation, living lung lobe donation), the donor evaluation process including medical, surgical, and psychosocial assessments, and the independent donor advocate (IDA) role.

The consent documents the surgical risks specific to the donation procedure including general anesthesia risks, intraoperative complications (hemorrhage, vascular injury, bile duct injury for hepatic donors, ureteral injury for renal donors), post-operative pain management, wound complications, venous thromboembolism, and long-term health considerations such as the residual risk of renal insufficiency for kidney donors or hepatic regeneration expectations for liver donors. The form explicitly addresses the possibility that the recipient surgery may be cancelled after the donor operation has begun, and that there is no guarantee of transplant success for the recipient.

Financial disclosure sections cover the donor's rights regarding prohibition of organ sale (National Organ Transplant Act), the recipient's insurance coverage of donor surgical costs, the donor's responsibility for lost wages and travel expenses (with information about the National Living Donor Assistance Center), and the potential impact on the donor's future health and life insurance eligibility. The form captures confirmation of independent psychological evaluation, absence of coercion, and the donor's understanding that they may withdraw consent at any time without affecting their medical care. Signatures from the donor, independent donor advocate, and transplant surgeon create a complete regulatory-compliant record.