Financial Burden Borne by Laparoscopic Living Kidney Donors

Transplantation. 2017 Sep;101(9):2253-2257. doi: 10.1097/TP.0000000000001568.


Background: Living kidney donors have donation-related out-of-pocket costs (direct costs) and/or ongoing daily expenses while losing income (indirect costs). Yet there is little information about how much of a subjective burden these constitute for the donors.

Methods: From December 2003 through December 2014, we surveyed donors 6 months postdonation to determine their financial burden related to donation (on a scale of 1 to 10) and what resources were used to cover expenses.

Results: Of 1136 surveyed, 796 (70%) responded. Among respondents, mean age at donation was 43.6 ± 10.6 years, 64% were women, 96% were white, and 53% were related by blood to their recipient. Overall, 26% scored their financial burden as 5 or higher; 8% scored it as 8 or higher. Increased expenses were associated with a higher reported burden; however, significant burden was reported by some with no out-of-pocket expenses (presumably due to lost wages and continuing expenses). The burden was scored as 5 or higher by 27% of those employed outside the home (n = 660), 15% homemakers, 13% retirees, 40% students; 28% unemployed; and 26% whose occupation was unknown. Over half (51%) of those receiving a local or (means-tested) national grant still reported moderate to severe burden. Besides grants, donors used a variety of sources to help offset expenses: dipped into savings, borrowed from friends or family, took out a loan, and/or had a fundraiser. Those with the highest burden reported using the most additional sources.

Conclusions: Donors should not have to incur costs or a financial burden to donate; the transplant community should strive to make donation financially neutral.

MeSH terms

  • Absenteeism
  • Adult
  • Economic Recession
  • Female
  • Financing, Personal*
  • Health Care Costs*
  • Health Care Surveys
  • Health Expenditures*
  • Humans
  • Kidney Transplantation / adverse effects
  • Kidney Transplantation / economics*
  • Kidney Transplantation / methods
  • Laparoscopy / adverse effects
  • Laparoscopy / economics*
  • Living Donors*
  • Male
  • Middle Aged
  • Nephrectomy / adverse effects
  • Nephrectomy / economics*
  • Salaries and Fringe Benefits / economics
  • Sick Leave / economics
  • Time Factors
  • Treatment Outcome
  • United States