Direct and Indirect Costs Following Living Kidney Donation: Findings From the KDOC Study

Area of Science:

• Nephrology
• Transplantation
• Health Economics

Background:

• Living kidney donation is crucial for addressing organ shortages.
• Living kidney donors (LKDs) may incur substantial costs, impacting their financial well-being.
• Current data on the financial impact of living kidney donation in the US is limited.

Purpose of the Study:

• To characterize the direct and indirect costs experienced by living kidney donors (LKDs) in the 12 months following donation.
• To identify factors associated with increased financial burden for LKDs.
• To highlight the need for financial support and neutrality for living kidney donors.

Main Methods:

• Prospective cohort study (Kidney Donor Outcomes Cohort - KDOC) involving 182 LKDs.
• Collection of cost data, including direct expenses and lost wages, over a 12-month post-donation period.
• Statistical analysis to determine the prevalence of costs and identify associated factors (e.g., travel distance, income, unpaid work hours).

Main Results:

• 92% of LKDs reported at least one direct cost (e.g., transportation, healthcare, meals, medications).
• LKDs lost over 33,000 work hours, resulting in $302,175 in lost wages, with caregivers losing an additional $68,655.
• 89% of LKDs experienced a net financial loss within 12 months, with 33% losing over $2500; financial burden correlated with travel distance, lower income, and unpaid work hours.

Conclusions:

• Living kidney donation imposes a significant financial burden on a majority of donors.
• Financial assistance and policies are needed to mitigate costs and lost wages for LKDs.
• Achieving financial neutrality for living kidney donors is an urgent priority for stakeholders in organ transplantation and public health.