One of the pre-conditions to be approved for organ transplant in any program in the US is to have family or friends willing to be with you 24 hours a day for at least the first month after you go home. Some transplant centers name that a 24hr care contract. The caregivers, usually more than one person is needed but exception can be granted, need to sign the plan. The contract needs to show which caregiver and when they will be present to take care of the patients when he or she goes home. It is almost like signing up for a shift at a job!
The caregiver screening is usually done by a social worker specialized in organ transplant so they know what is expected from the family. The social worker meets with all parties who are showing interest in being a caregiver, including the patient. They ask question to find out almost everything about their life. They need to know what you do for a living, education level, psycho social history, etc. The more we know about the family dynamic, the easier it is to work with the family to make it work. Some families need guidance as far as how to deal with all that. Organ transplant affects everybody, not just the recipient.
It is fairly rare that someone gets denied based only on the social worker professional opinion. At least it helps the staff get ready to deal with the family after the transplant because we know that some families will be difficult to deal with for several reasons. We usually don’t have much time to make the right assessment with the sicker patients because things move fast.
Unfortunately, it happens that the family members motivation dwindles after the transplant and patients are left by themselves. This is when trouble starts for them. Some run out of medications while others stop showing up at follow-ups and have untreated rejection. For us, transplant professional, it is frustrating because we could have given the valuable organ to somebody else. It is sad to see when it involves young patients who sometimes become narcotic (pain medicines) abusers.
It is very important that you have family or friends support for the first 3 months at a minimum after you go home, providing there is no major complication. They play an important role in making the transplant process as successful as it can be. Without family support, whether it is for kidney transplant, lung transplant or any other organ, it will be very difficult to have a positive outcome.