I received the results of Mr. McGrath’s surgical fitness tests and wanted to review them with you. His EKG and cardiac stress tests were both within normal limits. His chest X-ray was unremarkable, indicating no problems with his lung function. Finally, his HIV test was negative. Based on these results, he is clearly a good candidate for surgery. Now I need you to share these findings with him and determine how we go about getting an organ for him.

Where will we find an organ for Mr. McGrath?
As you know, organs are scare resources - there are more people who need organs than there are organs available. Remember how we calculated his MELD score and added his name to the UNOS list? Well, because of his low score of 22 (out of a possible 40), UNOS has advised us that it will be at least 6 to 8 months before he can possibly hope to receive an organ.

I’m concerned about this wait for many reasons. Mr. McGrath’s condition has become so much worse over the last year that by the time he reaches the top of the list, he may be too sick to be eligible for a transplant. Additionally, even when he reaches the top of the list, there is no guarantee that he will receive a liver. I think we need to consider the option of a live donor liver transplant.

To avoid any potential coercion issues, all potential donors must contact the hospital directly to express their interest in donating. The hospital can’t call anyone, nor can potential donors express their interest through the McGrath family. It will be up to Mr. McGrath to get the word out to his friends and family about his need for a liver transplant. He needs to have a solid understanding of what makes a good donor, so he can explain the requirements to people who might be interested.

Next Steps
I want you to prepare a report for Mr. McGrath. I’ve attached the Patient Notification Report Template to help you organize your work. Your report should:

• Explain his surgical fitness test results and why they indicate he is a good candidate for surgery.
  
  
• Explain the option of live organ donation, including answers to the following questions:
  • What is live organ donation and why is it a good option for Mr. McGrath?
  • Who can be a live donor and what are the important characteristics of a live donor?
    
    
• Finally, give Mr. McGrath clear instructions on what he needs to do next.

Your report will be an important reference for Mr. McGrath, so I’d like to review it before you give it to him.

Thanks,
Dr. Laura Schaffer, M.D.
Attending Physician
Divison of Hepatology
Lincoln Regional Medical Center