Purpose: An increasing number of U.S. patients die waiting for a kidney transplant. Financial compensation of living donors is one possible remedy for the organ shortage. A professionally designed quantitative survey was carried out to determine voting U.S. citizens' attitudes regarding financial compensation of living kidney donors.

Methods: 1,011 registered likely U.S. voters were asked willingness to donate a kidney and the potential influence of compensation ($50,000). Random digit dialing via both landlines and cell phones assured optimum population representation. Demographics included age, income, education level, gender, ethnicity, political affiliation, and employment. Outcome measures included the degree to which U.S. voters were willing to donate a kidney, and perceptions toward paying live kidney donors.

Results: Of 1,011 respondents, 689 (68%) indicated they would donate a kidney to anyone, 235 (23%) only to certain persons and 87 (9%) would not donate. A majority (59%) indicated payment of $50,000 would make them more likely to be a donor, 32% were unmoved, and 9% less likely. The majority of each age group supported compensation in principle, but support increased with lower age: 78% of voters ages 18-29 favored payment vs. 63% aged 30-44 and 58% > 45 years (p<0.05). By annual household income, 68% of those earning less than $50,000 favored compensation, higher than other income levels (p< 0.05). Still, 58% of those earning $50,000 – $100,000 and 56% of those earning more than $100,000 favored payment.

Conclusions: These findings suggests most U.S. voters would consider living kidney donation, and more importantly, would be motivated further toward donor nephrectomy if offered a payment of $50,000 regardless of age or income level. These findings counter the argument that the U.S. public would be opposed to financial compensation for living kidney donation and that financial compensation would reduce donation rates. Surveys do not always reflect behavior. However, the public support appears to be there to modify laws prohibiting donor financial compensation to permit pilot studies and explore the potential for financial incentives for living kidney donation to reduce the organ shortage.

CITATION INFORMATION: Fisher J, Peters T, Gish R, Howard R. Compensating Live Kidney Donors: The Views of United States Voters. Am J Transplant. 2016;16 (suppl 3).

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