Insurability of Living Organ Donors: A Systematic Review

Yang, Robert C.; Thiessen‐Philbrook, Heather; Klarenbach, Scott; Vlaicu, Sorina; Garg, Amit X.

doi:10.1111/j.1600-6143.2007.01793.x

Cited by 51 publications

(33 citation statements)

References 59 publications

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“…Outcomes for living kidney donors, such as perioperative complications, [12][13][14] psychosocial health, [15][16][17] and economic and insurability consequences, [18][19][20][21] are described elsewhere, as are outcomes for kidney recipients in relation to donor characteristics. 22,23 In this Review, we summarize studies that examine long-term medical outcomes for living kidney donors within the decade after donation, focusing on outcomes that can plausibly be associ ated with a reduction in GFR.…”

Section: Introductionmentioning

confidence: 99%

Long-term medical risks to the living kidney donor

et al. 2015

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Living kidney donation benefits recipients and society but carries short-term and long-term risks for the donor. This Review summarizes the studies that underlie our current understanding of these risks in the first decade after donation, with a view to improving the informed consent process. Two studies report a higher risk of end-stage renal disease (ESRD) among donors than among healthy nondonors; however, the absolute 15-year incidence of ESRD is <1%. All-cause mortality and the risk of cardiovascular events are similar among donors and healthy nondonors, although one study provides evidence for a 5% increase in all-cause mortality after 25 years that is attributable to donation. Some evidence suggests that the 20-year incidence of gout is slightly higher among donors than among healthy nondonors. The risks of gestational hypertension or pre-eclampsia seem to be 6% higher in pregnancies among donors than in pregnancies among healthy nondonors. The incidences of acute kidney injury, kidney stones that require surgical intervention, gastrointestinal bleeding and fractures seem no higher among donors than among healthy nondonors, although some of these conclusions are based on a small number of events. Future studies must clarify the lifetime incidence of long-term outcomes, particularly in relation to a donor's age, race, and history of comorbidities.

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Section: Introductionmentioning

confidence: 99%

Long-term medical risks to the living kidney donor

et al. 2015

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“…All medically eligible patients can have access to an organ regardless of their financial circumstances. Furthermore, potential donors in a nationally funded health care system will have access to free health care post operatively and well beyond, and should not, following their act of kindness, be subject to encountering any difficulty in securing medical insurance which can be the case in the absence of a national health care system [46].…”

Section: An Important Feature: a National Health Care Systemmentioning

confidence: 99%

Compensated Living Kidney Donation: A Plea for Pragmatism

2009

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Kidney transplantation is the most efficacious and cost-effective treatment for end-stage renal disease. However, the treatment's accessibility is limited by a chronic shortage of transplantable kidneys, resulting in the death of numerous patients worldwide as they wait for a kidney to become available. Despite the implementation of various measures the disparity between supply and needs continues to grow. This paper begins with a look at the current treatment options, including various sources of transplantable kidneys, for end-stage renal disease. We propose, in accordance with others, the introduction of compensated kidney donation as a means of addressing the current shortage. We briefly outline some of the advantages of this proposal, and then turn to examine several of the ethical arguments usually marshaled against it in a bid to demonstrate that this proposal indeed passes the ethics test. Using available data of public opinions on compensated donation, we illustrate that public support for such a program would be adequate enough that we can realistically eliminate the transplant waiting list if compensation is introduced. We urge a pragmatic approach going forward; altruism in living kidney donation is important, but altruism only is an unsuccessful doctrine.

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“…There (12) found that almost all insurance companies would provide life and health insurance to living organ donors, usually with no higher premiums. However, concern about insurability was still expressed by 2-14% of living organ donors in follow-up studies, and 3-11% of donors actually encountered difficulties with their insurance.…”

Section: Why Do Donors Need Long-term Medical Insurance?mentioning

confidence: 99%

The System of Health Insurance for Living Donors Is a Disincentive for Live Donation

Ommen

Gill

2010

American Journal of Transplantation

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The health insurance system for living donors is derived from insurance policies designed to cover accidental death or dismemberment. The system covers only the direct consequences of organ removal, and recoups the costs of related medical services from the transplant recipient's health insurance provider. The system forces transplant programs to differentiate between health services that are, or are not directly attributable to donation and may compromise the pretransplant evaluation, postoperative care and longterm care of living donors. The system is particularly problematic in the United States, where a significant proportion of donors do not have medical insurance. The requirement to assign donor costs to a particular recipient is poorly suited to facilitate advances in living donation such as the use of nondirected donors and living-donor paired exchange programs. We argue that given the current understanding regarding the long-term risks of living donation, the provision of basic medical insurance is a necessity for living donation and that the system of attributing donor costs to the recipient's insurance is inefficient, has the potential to undermine the care of living donors and is a disincentive to the expansion of living donation.

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Insurability of Living Organ Donors: A Systematic Review

Cited by 51 publications

References 59 publications

Long-term medical risks to the living kidney donor

Long-term medical risks to the living kidney donor

Compensated Living Kidney Donation: A Plea for Pragmatism

The System of Health Insurance for Living Donors Is a Disincentive for Live Donation

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