Eliminating financial disincentives to living kidney donation – a call to action

Polireddy, Karunesh; Crepeau, Rebecca L.; Matar, Abraham J.

doi:10.3389/fmed.2023.1061342

Front. Med.

2023

DOI: 10.3389/fmed.2023.1061342

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Eliminating financial disincentives to living kidney donation – a call to action

Karunesh Polireddy

Rebecca L. Crepeau

Abraham J. Matar

Abstract: The incidence of end stage renal disease (ESRD) in the United States (US) is increasing each year. The lone curative treatment for ESRD remains kidney transplantation. Despite the demonstrated medical and economic benefits, living donor kidney transplantation (LDKT) only accounts for a small number of kidney transplantations each year. Direct and indirect costs exist that disincentivize potential living kidney donors from coming forward, such as the cost of travel and lodging, risk of death, potential loss of … Show more

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How Do Financial Obstacles Affect Decision-Making Among Potential Living Organ Donors?

Mandell,

Smith,

Gifford

et al. 2024

Prog Transpl

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Introduction: Living donation increases the organ supply, but associated non-medical expenses can disincentivize donation. Programs aimed at increasing living donation need to better understand how financial obstacles, including lost wages, impact the decision to pursue donation. Methods/Approach: Forty-eight interviews were conducted and analyzed using a grounded theory approach. Findings: Three key themes were identified that influenced decision-making: emotional attachment, temporal flexibility, and job security. These themes emerged when dividing interview participants into 3 groups: close relationship donors, broader network donors, and non-directed donors, representing donation to a family member or friend, a specific person they do not know well or at all, or a non-specified individual, respectively. Most close relationship donors wanted to donate regardless of personal financial cost, based on emotional attachment to the recipient. Wage reimbursement did not typically affect their decision-making but could reduce stress. Since non-directed donors did not donate to a specific individual, they could wait to achieve financial stability before donating, if needed. While wage reimbursement might create more proximate stability, non-directed donors had the flexibility to postpone donations until they could independently achieve financial stability. Lacking emotional attachment and temporal flexibility, broader network donors were particularly active decision-makers and most influenced by wage reimbursement. Across all groups, donors with job security were more resolute about donating. Conclusion: The findings underscore the importance of lost wage reimbursement to facilitate donation and reduce stress, and policies to protect donor job security.

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How Do Financial Obstacles Affect Decision-Making Among Potential Living Organ Donors?

Mandell,

Smith,

Gifford

et al. 2024

Prog Transpl

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Global transplantation: Lessons from organ transplantation organizations worldwide

Symeou,

Avramidou,

Papalois

et al. 2025

World J Transplant

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Although national transplant organizations share common visions and goals, the creation of a unified global organization remains impractical. Differences in ethnicity, culture, religion, and education shape local practices and infrastructure, making the establishment of a single global entity unfeasible. Even with these social disparities aside, logistical factors such as time and distance between organ procurement and transplantation sites pose significant challenges. While technological advancements have extended organ preservation times, they have yet to support the demands of transcontinental transplantations effectively. This review presents a comparative analysis of the structures, operational frameworks, policies, and legislation governing various transplant organizations around the world. Key differences pertain to the administration of these organizations, trends in organ donation, and organ allocation policies, which reflect the financial, cultural, and religious diversity across different regions. While a global transplant organization may be out of reach, agreeing on best practices for the benefit of patients is essential.

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Eliminating financial disincentives to living kidney donation – a call to action

Cited by 2 publications

References 22 publications

How Do Financial Obstacles Affect Decision-Making Among Potential Living Organ Donors?

How Do Financial Obstacles Affect Decision-Making Among Potential Living Organ Donors?

Global transplantation: Lessons from organ transplantation organizations worldwide

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