Dissolving Disincentives to Living Kidney Donation

Area of Science:

• Nephrology
• Transplantation Surgery
• Public Health Policy

Background:

• Living donor kidney transplantation has seen record numbers, with a 24% increase from 2014-2019.
• Despite this growth, the demand for kidneys significantly outpaces the supply, leading to a growing waiting list.
• Barriers and disincentives continue to limit the number of living kidney donors.

Purpose of the Study:

• To identify and propose innovative solutions to overcome disincentives for living kidney donation.
• To advocate for policy changes and improved donor education to increase the number of living kidney donors.
• To address the gap between kidney transplant demand and supply through enhanced donor recruitment strategies.

Main Methods:

• Reviewing current barriers and disincentives to living kidney donation.
• Proposing legislative and regulatory changes to reimburse donors for all donation-related expenses.
• Recommending comprehensive donor education on various donation pathways (directed, non-directed, paired exchange, remote, advanced) and transplant center programs (e.g., National Kidney Registry Donor Shield).
• Emphasizing the importance of educating donors on personal risks and dispelling misinformation.

Main Results:

• A record 6,867 living donor kidney transplants were performed in 2019.
• A 24% increase in living donor kidney transplants was observed between 2014 and 2019.
• Despite increases, the supply of living donors remains insufficient to meet the rising demand for kidney transplants.

Conclusions:

• Innovative solutions are crucial to increase living kidney donation rates.
• Reimbursing donors for all expenses and providing comprehensive education on donation options and risks are key strategies.
• A standardized national approach is needed to address state-level variability in work leave and financial incentives for living donation.