Living kidney donation rates are declining; one cause may be the extent of the unreimbursed expenses associated with donation. We studied financial burden in a cohort of former donors.

Between 2003 and 2014, 1137 donors were surveyed regarding financial burden. Participants were asked to rank their burden from 0 to 10 (none – extreme), and to describe how expenses were addressed.

Results: Of the 1137, 794 (70%) responded. Of respondents, mean age at donation was 43.7 ± 11 years, 63% were female, 94% white, and 53% related to the recipient. At the time of donation 77% were employed part/full time and 84% had health insurance. Nonresponders were younger at donation; non-white; male; donated longer ago; and a higher proportion were related to their recipient (p <0.05 for each).

Overall, 27% ranked their financial burden as ≥5; 8% ≥8. Burden was ranked ≥5 by 28% of those employed; 10% homemaker; 12% retired; 0% students; 27% unemployed; 25% whose occupation was unknown; 25% with insurance; 37% without. Out-of-pocket expenses were reported by 617 (78%); 412 (52%) paid > $100; 167 (21%) >$500; Increasing expenses were associated with increasing reported burden (Table 1).

To cover expenses 36% used money from savings, 24% received a local and/or national grant, 15% borrowed money from family, 7% held a fundraiser, and 5% obtained a bank loan. Table 2 shows the number of these defined supplemental funds used; increasing burden was associated with increasing use of resources. 18% also reported difficulty paying bills.

Conclusion: Remarkably, 78% of LKDs paid for medical and/or non-medical expenses and 21% exceeded $500. Donors should not have to pay for the privilege to donate, and we should strive to create methods to achieve zero out-of-pocket expenses.

Table 1. Out-of-pocket expenses by ranking of financial burden:

Table 2. Amount of additional funds used by ranking of financial burden (%):

« Back to 2015 American Transplant Congress