*Purpose: OPTN requires transplant centers follow living donors (LDs) at 6 months, 1 year and 2 years post donation with a minimum threshold of 95% timeliness of submission. Due to poor compliance, we initiated a multidisciplinary QAPI project which dramatically improved compliance in a short period of time.

*Methods: Staff were educated on OPTN requirements. Policy change required LDs to follow up with the transplant team (previously, urology). Appointments were scheduled with patients who donated between 1/2014-2/2017. A database was developed to monitor follow up attempts and TIEDI form submission. A Living Donor Day was held to rapidly improve compliance. A form was created to ensure required information was obtained. Donors met with a physician, ILDA, coordinator and phlebotomist. During Phase 1, weekly multidisciplinary meetings including senior leadership were held to discuss form status, upcoming appointments and other challenges. During Phase 2 weekly emails replaced meetings. New donors are educated on follow up requirements during evaluation, and receive a letter immediately post-donation with expected follow up appointment dates. Results are reported at QAPI meetings.

*Results: Initially, 46 donors had 113 forms due with 53% submitted (1/2014-2/2017) complete. Within 29 days, 8 weeks, 6 months and 15 months post-change, 78%, 88%, 89% and 92% of forms were submitted complete (figure 1). 11 patients refused follow up. Reasons included recipient complication, post-op pain, and psychosocial issues. TIEDI forms were submitted as “patient not seen” approx. 8 weeks post-policy change for these patients. Pre-policy, 31% of forms were submitted on time. Since initiation of the project, for donors from 1/2017-4/2018, 58 forms were due of which 98% were submitted on time (figure 2). Of 86 LDs between 1/2014-4/2018, 60% lived local, 23% out of state, 15% international.

*Conclusions: Improving LD follow up requires a multidisciplinary approach. For programs that are behind in form submission, holding a Living Donor Day with standardized forms and workflow can quickly improve compliance. Frequent education for donors and early scheduling of f/u appointments can maintain excellent post donation follow up rates.

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