Living Donors Served by a Different Program. This letter addresses Medicare requirements for transplant programs and surveyor activities in which some or all of the services for a living donor are provided by a program other than the transplant program of the organ recipient. These can be ongoing arrangements between two hospitals or can be episodic arrangements as part of a single donation or multi-organ exchange. Responsibility of Recipient Transplant Program. The organ recipients transplant program must have evidence of a written agreement or contract with the living donor organ program and is responsible for ensuring that certain minimum quality standards are met for each donor organ it receives. Finalizes Interim Guidance, S&C 11-40-Transplant. This memorandum replaces the interim guidance that was previously released September 30, 2011.