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Public Survey of Acceptable Financial Incentives for Living Donation: Challenging Assumptions and Reinvigorating the Debate, A

C. Patel, M. Sohn, B. Hippen, L. Sherman, E. Gordon

Northwestern University, Chicago
Case Western Reserve University, Cleveland
Carolinas Medical Center, Charlotte

Meeting: 2013 American Transplant Congress

Abstract number: 311

Background. The potential use of financial incentives to increase living kidney donation rates has generated much controversy over the potential for exploitation of and undue pressure on vulnerable populations to donate. However, little is known as to when financial incentives would begin to motivate and to place undue pressure on people to donate. This study aimed to assess the amount of financial incentive that would generate both motivation and an undue inducement to donate to family members/friends and to strangers.

Methods. An anonymous survey was administered to individuals leaving six Departments of Motor Vehicles to capture a cross-section of the population. The self-administered survey included 26 closed- and open-ended questions prepared at a 7th grade reading level.

Results. 210 individuals completed the survey (94% participation rate). The average age was 41 years; 54% were male; 50% were white, 21% black, 16% Hispanic; all had at least a high school education, and had incomes lower than (30%), equal to (31%) or higher (33%) than $40,000-$79,999. Most (90%) respondents were probably or definitely willing to donate to family/friends, while fewer (17%) were probably or definitely willing to donate to strangers. Respondents’ willingness to donate to family/friends with an offer of financial compensation would increase (28%), stay the same (70%), or decrease (1%). The median lowest amount of financial compensation that would make participants begin to consider donating a kidney was $5,000 for family/friends, and $50,000 for strangers. The median lowest amount of financial compensation for which participants could no longer decline was $10,000 for family/friends, and $100,000 for strangers. Financial amounts were not associated with income or other sociodemographics in multivariable analysis. Respondents’ most preferred forms of compensation were a direct payment of money (61%), paid leave (21%), and tax credit (8%). Respondents’ preferred use of compensation included: paying off debt (38%), paying for non-medical expenses associated with transplant (29%), and putting money into a savings account (14%).

Conclusions. These findings suggest that, contrary to expectation, there are monetary amounts of financial compensation that could motivate the public to donate without being perceived as coercive.

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To cite this abstract in AMA style:

Patel C, Sohn M, Hippen B, Sherman L, Gordon E. Public Survey of Acceptable Financial Incentives for Living Donation: Challenging Assumptions and Reinvigorating the Debate, A [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/public-survey-of-acceptable-financial-incentives-for-living-donation-challenging-assumptions-and-reinvigorating-the-debate-a/. Accessed May 14, 2025.

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