title: Direct and Indirect Costs Following Living Kidney Donation: Findings From the KDOC Study.
abstract: Some living kidney donors (LKDs) incur costs associated with donation, although these costs are not well characterized in the United States. We collected cost data in the 12 mo following donation from 182 LKDs participating in the multicenter prospective Kidney Donor Outcomes Cohort (KDOC) Study. Most LKDs (n = 167, 92%) had one direct cost or more following donation, including ground transportation (86%), health care (41%), meals (53%), medications (36%), lodging (23%), and air transportation (12%). LKDs missed 33 072 total work hours, 40% of which were unpaid and led to $302 175 in lost wages (mean $1660). Caregivers lost $68 655 in wages (mean $377). Although some donors received financial assistance, 89% had a net financial loss in the 12-mo period, with one-third (33%) reporting a loss exceeding $2500. Financial burden was higher for those with greater travel distance to the transplant center (Spearman's ρ = 0.26, p < 0.001), lower household income (Spearman's ρ = -0.25, p < 0.001), and more unpaid work hours missed (Spearman's ρ = 0.52, p < 0.001). Achieving financial neutrality for LKDs must be an immediate priority for the transplant community, governmental agencies, insurance companies, nonprofit organizations, and society at large.
authors: Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA.|Harvard Medical School, Boston, MA.
authors: J R
authors: JR
authors: Rodrigue
authors: Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH.
authors: J D
authors: JD
authors: Schold
authors: Transplant Center, Rhode Island Hospital, Providence, RI.
authors: P
authors: P
authors: Morrissey
authors: Maine Transplant Center, Maine Medical Center, Portland, ME.
authors: J
authors: J
authors: Whiting
authors: Maine Transplant Center, Maine Medical Center, Portland, ME.
authors: J
authors: J
authors: Vella
authors: Montefiore Einstein Center for Transplantation, Bronx, NY.|Regional Center of Excellence for Transplantation and Kidney Care, Erie County Medical Center, University of Buffalo, Buffalo, NY.
authors: L K
authors: LK
authors: Kayler
authors: Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA.
authors: D
authors: D
authors: Katz
authors: Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA.
authors: J
authors: J
authors: Jones
authors: Department of Medicine, University of Arizona, Tucson, AZ.|School for the Science of Health Care Delivery, Arizona State University, Phoenix, AZ.
authors: B
authors: B
authors: Kaplan
authors: Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA.
authors: A
authors: A
authors: Fleishman
authors: Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA.|Harvard Medical School, Boston, MA.
authors: M
authors: M
authors: Pavlakis
authors: 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: D A
authors: DA
authors: Mandelbrot
mesh_terms: D000328:Adult; 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; D009392:Nephrectomy / Q000191:economics*; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011446:Prospective Studies; D020858:Tissue and Organ Harvesting / Q000191:economics*
keywords: clinical research/practice; donors and donation: donor follow-up; donors and donation: living; economics; kidney transplantation/nephrology; social sciences