Socioeconomic Status in Non-directed and Voucher-based Living Kidney Donation

Eur Urol Focus. 2018 Mar;4(2):185-189. doi: 10.1016/j.euf.2018.07.020. Epub 2018 Aug 16.


Background: Little has been reported about the socioeconomic status (SES) and demographics of non-directed (altruistic) and voucher-based donation.

Objective: To analyze common characteristics amongst altruistic donors in order to promote non-directed and voucher-based donation.

Design, setting, and participants: Information regarding altruistic donations from 2008 to 2015 and voucher-based donors was obtained from the National Kidney Registry.

Outcome measurements and statistical analysis: An SES index, created and validated by the Agency for Healthcare Research and Quality (AHRQ), was created by geocoding the donor's zip code and linking it to seven publicly available SES variables found in the 2010 United States Census data.

Results and limitations: In total, 267 non-directed and 3 voucher-based donations were identified. Non-directed donors were predominantly female (58%), with an average age of 45.6 yr (range, 21-72). The mean SES index score was 55.6 (SD=3.2), which corresponds to the 77th percentile of 1.5 million MediCare beneficiaries as reported by the AHRQ in 2008. Voucher-based donors were Caucasian males of high SES. The study was limited by the number of voucher-based donations.

Conclusions: Non-directed and voucher-based donors are in the upper end of the economic spectrum. The voucher-based program has built within it the inherent capacity to remove disincentives to donation, which currently limit altruistic donation.

Patient summary: We wanted to determine what types of people donated their kidneys altruistically, so that we could understand how to motivate more people to donate their kidneys. The voucher-based program was recently started and is a promising tool to motivate many people to donate kidneys by removing major disincentives to donation.

Keywords: Altruistic kidney donation; Kidney Transplantation Non-directed donation; Voucher Program; Voucher-based kidney donation.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Altruism
  • Directed Tissue Donation
  • Female
  • Humans
  • Kidney Transplantation / economics
  • Living Donors / psychology*
  • Living Donors / statistics & numerical data
  • Male
  • Middle Aged
  • Motivation
  • Registries
  • Social Class*
  • Tissue and Organ Harvesting / economics
  • Tissue and Organ Harvesting / methods*
  • Tissue and Organ Procurement / economics
  • Tissue and Organ Procurement / methods*
  • United States / epidemiology
  • United States Agency for Healthcare Research and Quality / ethics