Living organ donors face financial barriers: A national reimbursement policy is needed

Klarenbach, Scott; Garg, Amit X.; Vlaicu, Sorina

doi:10.1503/cmaj.051168

Cited by 40 publications

(29 citation statements)

References 7 publications

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“…Harms may be minimized through careful donor selection (32,71,78). Also, health policies which fairly reimburse live organ donors for their nonmedical expenses may help reduce undue stress (81,82).…”

Section: Informed Consent Support and Follow-upmentioning

confidence: 99%

Psychosocial Health of Living Kidney Donors: A Systematic Review

Clemens

Thiessen‐Philbrook

Parikh

et al. 2006

American Journal of Transplantation

252

213

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Knowledge of the psychosocial benefits and harms faced by living kidney donors is necessary for informed consent and follow-up. We reviewed any English language study where psychosocial function was assessed using questionnaires in 10 or more donors after nephrectomy. We searched MEDLINE, EM-BASE, Web of Science, Psych INFO, Sociological Abstracts and CINAHL databases and reviewed reference lists from 1969 through July 2006. Independently, two reviewers abstracted data on study, donor and control group characteristics, psychosocial measurements and their outcomes. Fifty-one studies examined 5139 donors who were assessed an average of 4 years after nephrectomy. The majority experienced no depression (77-95%) or anxiety (86-94%), with questionnaire scores similar to controls. The majority reported no change or an improved relationship with their recipient (86-100%), spouse (82-98%), family members (83-100%) and nonrecipient children (95-100%). Some experienced an increase in self-esteem. A majority (83-93%) expressed no change in their attractiveness. Although many scored high on quality of life measures, some prospective studies described a decrease after donation. A small proportion of donors had adverse psychosocial outcomes. Most kidney donors experience no change or an improvement in their psychosocial health after donation. Harms may be minimized through careful selection and follow-up.

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Section: Informed Consent Support and Follow-upmentioning

confidence: 99%

Psychosocial Health of Living Kidney Donors: A Systematic Review

Clemens

Thiessen‐Philbrook

Parikh

et al. 2006

American Journal of Transplantation

252

213

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“…Multiple strategies to increase living donation have been proposed, including limiting financial disincentives for living donors (6)(7)(8)(9). Recently, we conducted a survey examining the acceptability of financial incentives to increase the number of kidneys for transplantation (10).…”

Section: Introductionmentioning

confidence: 99%

The Cost-Effectiveness of Using Payment to Increase Living Donor Kidneys for Transplantation

Barnieh¹,

Gill²,

Klarenbach³

et al. 2013

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives For eligible candidates, transplantation is considered the optimal treatment compared with dialysis for patients with ESRD. The growing number of patients with ESRD requires new strategies to increase the pool of potential donors.Design, setting, participants, & measurements Using decision analysis modeling, this study compared a strategy of paying living kidney donors to waitlisted recipients on dialysis with the current organ donation system. In the base case estimate, this study assumed that the number of donors would increase by 5% with a payment of $10,000. Quality of life estimates, resource use, and costs (2010 Canadian dollars) were based on the best available published data.Results Compared with the current organ donation system, a strategy of increasing the number of kidneys for transplantation by 5% by paying living donors $10,000 has an incremental cost-savings of $340 and a gain of 0.11 quality-adjusted life years. Increasing the number of kidneys for transplantation by 10% and 20% would translate into incremental cost-savings of $1640 and $4030 and incremental quality-adjusted life years gain of 0.21 and 0.39, respectively.Conclusion Although the impact is uncertain, this model suggests that a strategy of paying living donors to increase the number of kidneys available for transplantation could be cost-effective, even with a transplant rate increase of only 5%. Future work needs to examine the feasibility, legal policy, ethics, and public perception of a strategy to pay living donors.

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“…They should also be helped to avoid any financial hardship as a consequence of donating their organ. The fear of medical or financial risks of organ donation could gravely lessen donation rates (11). A study on 133 potential donors revealed that 24% of them had not donated their organs due to their fear of facing financial hardship after donation (12).…”

Section: Introductionmentioning

confidence: 99%