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Adult Living Donor

Enhanced Recovery After Surgery (ERAS) pathways promote an evidence-based, multidisciplinary approach to patient care that facilitates faster recovery from surgery, reduces hospital length of stay, and minimizes post-operative complications. From scheduling through discharge, all phases of perioperative care are incorporated into ERAS pathways.   

ERAS Pathway: 

Additional tools associated with this ERAS Pathway: 

Inclusion and exclusion criteria: 

  • Inclusion: 
    • Adult > 21 years of age
    • No medical contraindication to donation
    • Donor competent and willing to donate 
    • Donor able and willing to comply with follow-up
    • Donor has a primary care physician and active health insurance  
  • Exclusion: Relative 
    • BMI > 30
    • > 55 years
    • Serious chronic medical illness 
    • Recent history of malignancy 
    • Chronic viral hepatitis 
  • Exclusion: Absolute 
    • Age < 21 years 
    • Deemed mentally incapable of making an informed decision 
    • Living with HIV 
    • Active or incompletely treated malignancy that either
      • Requires treatment other than surveillance 
        -or- 
      • Has more than minimal known risk of transmission 
    • High suspicion of knowingly and unlawfully acquiring, receiving, or otherwise transferring anything of value in exchange for any human organ  
      • Acute symptomatic infection (until resolved) 
      • Unsuitable donor anatomy 
  • Uncontrolled diagnosable psychiatric conditions requiring treatment before donation, including any evidence of suicidality 
  • Psychosocial instability or an unsupportive social environment 

For Kidney Donor Only: 

  • Uncontrolled hypertension or hypertensive end-organ damage 
  • Type 1 or 2 diabetes 

For Liver Donor Only: 

  • HCV RNA positive 
  • HBsAg positive 
  • ZZ, Z-null, null-null, S-null, or untypeable alpha-1 antitrypsin phenotype 
  • Remnant liver volume < 30% of native liver volume 
  • Prior living liver donation  

Committee members involved in the development: 

  • Hilary Sheridan, MD | Pediatric Anesthesiology | Committee Chair 
  • Nichole Doyle, MD, FASA, FAAP | Pediatric Anesthesiology | Committee Member 
  • Emily Weisberg, MD, FASA | Pediatric Anesthesiology | Committee Member
  • Gabriel Gallegos, MD |Pediatric Anesthesiology | Committee Member 
  • Andrew Bonham, MD, FACS | Transplant Surgery | Committee Member 
  • Tara Benton, MD, MSCI | Critical Care Medicine | Committee Member 
  • Amy Gallo, MD | Transplant Surgery | Committee Member 
  • Megan Faseler, BSN, RN, CPN, CCTC | Transplant Center |Committee Member 
  • Lindsey Patterson, BSN, RN | Transplant Center | Committee Member 
  • Heather Sambol, RN, APRN  | Pediatric Anesthesiology | Committee Member 

 EBP Committee Members: 

  • Todd Glenski, MD, MSHA, FASA | Anesthesiology, Evidence Based Practice 
  • Andrea Melanson, OTD, OTR/L | Evidence Based Practice 

 Publication dates: 

  • Finalized date: October 2026 
  • Next expected revision date: 2030 

Concerns with content: 

If you have any questions regarding this content or identify a broken link, please email evidencebasedpractice@cmh.edu.  

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.