Development of the National Living Donor Assistance Center: Reducing Financial Disincentives to Living Organ Donation

Abstract

Over the years, the transplant community has worked to advance the care of living organ donors; however, barriers remain, including the nonmedical expenses incurred by living donors. A new center, funded by a grant from the Health Resources and Services Administration (HRSA), was established to operate a nationwide system to remove these financial disincentives. The HRSA grant was awarded to an academic institution and the daily operations are managed by a transplant professional society. Expenses are reimbursed prospectively for financially needy living donors. Combining the legislative authority and economic resources of the federal government, the research experience of an academic institution, and the management know-how of a professional society has proven to be successful. To date, the center has received 3918 applications submitted by 199 different transplant centers and receives about 80 applications per month. On average, a donor spends $2767 for their travel expenses to the transplant center. Of the 3918 applications that have been submitted, 1941 of those applicants (50%) have completed their donor surgery.

Direct and Indirect Costs Following Living Kidney Donation: Findings From the KDOC Study

“…NLDAC provided the most financial support, both in percentage of donors helped (9%) and funds disbursed ($57 389); however, it is our impression that these financial assistance programs are fragmented, inaccessible to many donors, and limited in what types of expenses are reimbursable (1,10). NLDAC, for instance, considers the financial resources of both donors and their recipients in determining whether eligibility criteria are met, and legislation establishing the program specifically prohibits reimbursement of lost wages (1). Although NLDAC has provided financial assistance to %5% of LKDs since its inception, its reach could be expanded by removing financial eligibility requirements and paying for lost wages.…”

Living-Donor Kidney Transplantation

“…Starting in 2007, the National Living Donor Assistance Center (NLDAC) (via a Health Resources and Services Administration grant) began offering grants to offset travel costs for living donors and their supports (33). From its inception through August 2013, NLDAC received 3918 applications and approved 89% of them.…”

Living Donor Kidney Transplantation

“…Concern for out-of-pocket expenses, lost wages, job insecurity, and risk of insurability problems (health, life, disability) for living donors deters transplant candidates from pursuing LDKT and healthy adults from considering LKD. The National Living Donor Assistance Center (NLDAC) currently provides travel and lodging financial assistance to living donors who meet income eligibility criteria (70). Legislative authorization to expand the NLDAC to include reimbursement of lost wages (with an appropriate cap) and other direct expenses as well as the removal of financial means testing is an immediate priority to reduce the effects of class and racial disparities.…”