Multi-Center Examination of the Reliability and Validity of the Live Donor Assessment Tool (LDAT) as an Enhancement to the Psychosocial Evaluation of Living Donors
1RMTI, Mount Sinai Hosptial, NY, NY
2Mayo Clinic, Rochester, MN
3NYPH, NY, NY
4UCSF, San Francisco, CA.
Meeting: 2018 American Transplant Congress
Abstract number: D179
Keywords: Donors, Kidney, Living-related liver donors, Psychosocial, unrelated
Session Information
Session Name: Poster Session D: Kidney Living Donor: Selection
Session Type: Poster Session
Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Purpose: The LDAT is the first psychosocial assessment tool developed to standardize live donor (LD) psychosocial evaluations (PsychE). It assesses motivation, LD knowledge/expectations, support, closeness to the recipient, feelings about donation, stability in life, and psychiatric and addiction history. In a previous single center study, the LDAT reliably gave results similar to the PsychE. A multi-center study was conducted to further explore the reliability and validity of the LDAT and determine its ability to enhance the PsychE beyond its center of origin.
Methods: 4 transplant programs participated, each with their own team of evaluators and unique donor demographics. Consenting liver and kidney LDs (6-2015 to 9-2016) undergoing both standard PsychE and LDAT were studied. LDAT inter-rater reliability between providers, associations between LDAT scores and PsychE outcome, and psychosocial outcomes post-donation were tested. Further, the feasibility of administering and utilizing the LDAT across multiple transplant centers was investigated.
Results: 386 LD evaluations were compared. Mean age was 42.42 (SD=12.63) and LDAT score was 67.34 ±7.57 (shown as mean±SD). Ethnicity varied significantly by center. In 140 LDs with 2 LDATs by different observers, the inter-rater scores correlated with r=0.670, p<0.001.ANOVA demonstrated significant differences in LDAT scores according to the psychosocial risk level of the group and at each center (high risk: LDAT 53.18±7.77; moderate risk: LDAT=62.79±6.73; low risk: LDAT=70.50±5.13; p<0.001); 131 subjects proceeded with donation. LDAT scores were lower in LDs requiring post-donation counseling (t=-2.78, p=0.01). 
Conclusions: The LDAT is proven reliable and valid across centers. The results of this study demonstrate that the LDAT can indeed be used as standardized language among clinicians to communicate psychosocial risk of potential LD candidates. It can also assist teams anticipate post-donation psychosocial needs.
CITATION INFORMATION: LaPointe Rudow D., Jowsey-Gregoire S., Desrosiers F., Trompeta J., LDAT Study Group Multi-Center Examination of the Reliability and Validity of the Live Donor Assessment Tool (LDAT) as an Enhancement to the Psychosocial Evaluation of Living Donors Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Rudow DLaPointe, Jowsey-Gregoire S, Desrosiers F, Trompeta J, Group LDATStudy. Multi-Center Examination of the Reliability and Validity of the Live Donor Assessment Tool (LDAT) as an Enhancement to the Psychosocial Evaluation of Living Donors [abstract]. https://atcmeetingabstracts.com/abstract/multi-center-examination-of-the-reliability-and-validity-of-the-live-donor-assessment-tool-ldat-as-an-enhancement-to-the-psychosocial-evaluation-of-living-donors/. Accessed November 21, 2024.« Back to 2018 American Transplant Congress