GUIDELINES No recommendations possible based on Level I or II evidence SUGGESTIONS FOR CLINICAL CARE(Suggestions are based on Level III and IV evidence)• A formal psychosocial assessment should be a mandatory part of the pre-transplant workup process.• Semi-structured interview guides (for preoperative and postoperative psychosocial assessments) are useful for focussing the discussion on relevant and critical issues while allowing open discussion.• Education and assessment of potential donors is essential to identify 'high-risk' donors.• Donors should be followed-up for psychological care post-donation.• Donors with poor recipient outcomes should have extensive psychological support available.• A formal multidisciplinary approach should be taken in the event of negative recipient outcome. IMPLEMENTATION AND AUDITLiving kidney donors should undergo psychosocial assessment and have access to psychosocial care before and after the transplant surgery.

Renal transplant co-ordinators and pharmacists recognized the importance of early patient education concerning immunosuppressant medication. However, each site had developed their own way of preparing a patient for kidney transplantation and follow-up in the acute hospital setting based on experience and practice. Other non-educational strategies involving behavioural and emotional aspects were less common. Differences in usual care reinforce the necessity for evidence-based health care for best patient outcomes.

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The advance of renal replacement therapy options for people with end-stage kidney disease has given rise to the development of specialist renal nurses including the renal transplant coordinator. The renal transplant coordinator role requires a high level of specialist knowledge in renal and transplantation nursing plus a commitment to following through with people in the long term. To find out just what renal transplant coordinators in Australia do, an interview was conducted with renal transplant coordinators from each Australian state and territory. Their stories relate to transplanting units; referring centres; and, adult, paediatric, state-wide and national renal services. They demonstrate the diversity that exists within the role of the renal transplant coordinator.

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