title: Concern for Lost Income Following Donation Deters Some Patients From Talking to Potential Living Donors.
abstract: BACKGROUND
  Some living kidney donors report lost income during recovery from surgery. Little is known about whether concern for living donor's lost income affects the decision to undergo donation evaluation and the willingness of transplant candidates to discuss living kidney donation (LKD) with others.
  
  
  OBJECTIVE
  To examine whether transplant patients were told by potential donors about lost income concerns and whether patients chose not to discuss LKD with others due to lost income concerns.
  
  
  METHODS
  Kidney transplant patients (185 wait-listed candidates, 171 deceased donor recipients, and 100 live donor recipients) at 2 centers completed a questionnaire to assess whether concern about donor's lost income was a consideration in discussion about LKD with others.
  
  
  RESULTS
  One-third (32%) were told by a family member/friend that they were willing to donate but were concerned about potential lost income. The majority of those who expressed financial concern (64%) did not initiate donation evaluation. Many patients (42%) chose not to discuss living donation with a family member/friend due to concern about the impact of lost income on the donor. In the multivariable model, lower annual household income was the only statistically significant predictor of both having a potential donor expressing lost income concern and choosing not to talk to someone because of lost income concern.
  
  
  CONCLUSIONS
  Findings from the current study underscore how concern about income loss for living donors may affect decision-making by both transplant candidates and potential donors.
authors: 1 Center for Transplant Outcomes and Quality Improvement, The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA.|2 Harvard Medical School, Boston, MA, USA.
authors: James R
authors: JR
authors: Rodrigue
authors: 3 Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
authors: Jesse D
authors: JD
authors: Schold
authors: 4 Department of Medicine, University of Wisconsin, Madison, WI, USA.
authors: Didier A
authors: DA
authors: Mandelbrot
authors: 5 Department of Surgery, Medical University of South Carolina, Charleston, SC, USA.|6 Department of Pharmacy, Ralph H. Johnson VA Medical Center, Charleston, SC, USA.
authors: David J
authors: DJ
authors: Taber
authors: 5 Department of Surgery, Medical University of South Carolina, Charleston, SC, USA.
authors: Van
authors: V
authors: Phan
authors: 5 Department of Surgery, Medical University of South Carolina, Charleston, SC, USA.
authors: Prabhakar K
authors: PK
authors: Baliga
mesh_terms: D003657:Decision Making; D005382:Financing, Personal; D006801:Humans; D007182:Income; D016030:Kidney Transplantation; D019520:Living Donors; D011795:Surveys and Questionnaires; D014850:Waiting Lists
keywords: barriers; costs; kidney donation; kidney transplantation; living donation; transplant recipients