While financial barriers to living kidney donation have been recognized, and the associated costs have been characterized limited data exist on the costs incurred by living liver donors (LLDs).

Methods: We surveyed 15 LLDs at our institution (03/2015-07/2017) regarding non-reimbursed costs incurred during evaluation, hospitalization for donation, and post-donation recovery.

Results: The majority of participants were male (67%), Caucasian (93%), college-educated (73%), and employed (93%). The greatest source of donation-related cost was from missed work (reported by 73% of participants) with a median (IQR) loss of $3,000 ($1,600-$7,300). Two donors (13%) reported that time missed from work for donation threatened their job security. The next greatest cost was the lost pay and/or travel costs incurred by participants' companions (67%; median (IQR) $525 ($100-$2,000)); notably, every participant had at least one companion accompany them to an appointment and/or donation surgery. Median (IQR) total donation-related cost reported by participants was $3,261 ($2,183-$7,630), and 80% of participants had costs exceeding $1,000. Among participants, 13% perceived that living liver donation was financially burdensome, and 20% reported considering donation-related costs during their donation decision process.

Conclusions: Living liver donation associated out-of-pocket costs are substantial, with many LLDs spending thousands of dollars out of pocket during the evaluation, donation, and recovery period. Consequently, cost is a consideration for potential donors, and donation is financially burdensome for some LLDs. Mitigating costs to LLDs might improve access to living-donor liver transplantation.

CITATION INFORMATION: Ruck J., Massie A., Garonzik-Wang J., Ottman S., Cameron A., Philosophe B., Segev D. Living Liver Donors Face Substantial Out-of-Pocket Donation-Related Costs Am J Transplant. 2017;17 (suppl 3).

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