title: Predonation Direct and Indirect Costs Incurred by Adults Who Donated a Kidney: Findings From the KDOC Study.
abstract: Limited information exists on the predonation costs incurred by eventual living kidney donors (LKDs). Expenses related to completion of the donation evaluation were collected from 194 LKDs participating in the multi-center, prospective Kidney Donor Outcomes Cohort (KDOC) Study. Most LKDs (n = 187, 96%) reported one or more direct costs, including ground transportation (80%), healthcare (24%), lodging (17%) and air transportation (14%), totaling $101 484 (USD; mean = $523 ± 942). Excluding paid vacation or sick leave, donor and companion lost wages totaled $35 918 (mean = $187 ± 556) and $14 378 (mean = $76 ± 311), respectively. One-third of LKDs used paid vacation or sick leave to avoid incurring lost wages. Few LKDs reported receiving financial support from the transplant candidate (6%), transplant candidate's family (3%), a nonprofit organization (3%), the National Living Donor Assistance Center (7%), or transplant center (3%). Higher total costs were significantly associated with longer distance traveled to the transplant center (p < 0.001); however, total costs were not associated with age, sex, race/ethnicity, household income, marital status, insurance status, or transplant center. Moderate predonation direct and indirect costs are common for adults who complete the donation evaluation. Potential LKDs should be advised of these possible costs, and the transplant community should examine additional strategies to reimburse donors for them.
authors.affiliation: Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA.|Harvard Medical School, Boston, MA.
authors.forename: J R
authors.initials: JR
authors.lastname: Rodrigue
authors.affiliation: Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH.
authors.forename: J D
authors.initials: JD
authors.lastname: Schold
authors.affiliation: Transplant Center, Rhode Island Hospital, Providence, RI.
authors.forename: P
authors.initials: P
authors.lastname: Morrissey
authors.affiliation: Maine Transplant Center, Maine Medical Center, Portland, ME.
authors.forename: J
authors.initials: J
authors.lastname: Whiting
authors.affiliation: Maine Transplant Center, Maine Medical Center, Portland, ME.
authors.forename: J
authors.initials: J
authors.lastname: Vella
authors.affiliation: Montefiore Einstein Center for Transplantation, Bronx, NY.
authors.forename: L K
authors.initials: LK
authors.lastname: Kayler
authors.affiliation: Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA.
authors.forename: D
authors.initials: D
authors.lastname: Katz
authors.affiliation: Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA.
authors.forename: J
authors.initials: J
authors.lastname: Jones
authors.affiliation: Division of Internal Medicine, University of Kansas Medical Center, Kansas City, KS.|Department of Medicine, University of Arizona, Tucson, AZ.
authors.forename: B
authors.initials: B
authors.lastname: Kaplan
authors.affiliation: Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA.|Harvard Medical School, Boston, MA.
authors.forename: A
authors.initials: A
authors.lastname: Fleishman
authors.affiliation: Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA.|Harvard Medical School, Boston, MA.
authors.forename: M
authors.initials: M
authors.lastname: Pavlakis
authors.affiliation: Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA.|Department of Medicine, University of Wisconsin, Madison, WI.
authors.forename: D A
authors.initials: DA
authors.lastname: Mandelbrot
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003365:Costs and Cost Analysis; D005260:Female; D005500:Follow-Up Studies; D005102:Health Expenditures / Q000639:trends*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000191:economics*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000191:economics*; D011446:Prospective Studies; D009927:Tissue and Organ Procurement / Q000191:economics*; D055815:Young Adult
keywords: allied health/nursing; clinical research/practice; donor nephrectomy; donors and donation: incentives; donors and donation: living; economics; kidney transplantation/nephrology; kidney transplantation: living donor