If a donor requests, in advance, to re-direct their organ to a secondary recipient; the HTA would need to be satisfied that there is no duress, coercion and reward involved in the re-direction. For example, a father donating to his child at the same time that his wife also requires a transplant. In the unlikely event that the organ cannot be transplanted into the child, he may wish for the organ to go to his wife instead.
The decision about whether the secondary recipient is medically fit and clinically suitable, is a matter for the medical practitioners concerned.
The HTA would need to be satisfied that there is no duress, coercion and reward involved in the re-direction. Therefore, the transplant unit or referral unit will need to arrange two IA interviews:
- With the donor and the primary recipient; and
- With the donor and the secondary recipient.
The same IA can carry out both assessments and will have to submit two separate IA reports to account for the different recipients. Both of these reports should be submitted at the same time. Furthermore, the referral letter for both assessments should specifically document the re-direction request from the donor.
Before the IA assessments takes place, the clinical team would need to ensure that the donor:
- is aware of the likelihood of an organ requiring re-direction, and;
- is aware they should also decide what they wish to happen in the event that their organ cannot be transplanted into the intended secondary recipient. This information will be recorded in the second IA report.
The clinical team will also need to ensure that the secondary recipient:
- is a suitable match to receive the organ;
- understands the circumstances under which they may receive an organ; and
- recognises the likelihood of such an event occuring.
This information can also be found in the Guidance to Transplant teams and Independent Assessors.
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