Income of Living Kidney Donors and the Income Difference Between Living Kidney Donors and Their Recipients in the United States

Division of Nephrology, University of British Columbia, Vancouver, British Columbia, Canada Tufts-New England Medical Center, Boston, MA Center for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada Division of Nephrology, University of Calgary, Calgary, Alberta, Canada Department of Medicine, University of Alberta, Edmonton, Alberta, Canada Alberta Kidney Disease Network, Edmonton, Alberta, Canada.
American Journal of Transplantation (Impact Factor: 6.19). 08/2012; 12(11). DOI: 10.1111/j.1600-6143.2012.04211.x
Source: PubMed

ABSTRACT Disincentives for living kidney donation are common but are poorly understood. We studied 54 483 living donor kidney transplants in the United States between 2000 and 2009, limiting to those with valid zip code data to allow determination of median household income by linkage to the 2000 U.S. Census. We then determined the income and income difference of donors and recipients. The median household income in donors and recipients was $46 334 ±$17 350 and $46 439 ±$17 743, respectively. Donation-related expenses consume ≥ 1 month's income in 76% of donors. The mean ± standard deviation income difference between recipients and donors in transplants involving a wealthier recipient was $22 760 ± 14 792 and in 90% of transplants the difference was <$40 000 dollars. The findings suggest that the capacity for donors to absorb the financial consequences of donation, or of recipients to reimburse allowable expenses, is limited. There were few transplants with a large difference in recipient and donor income, suggesting that the scope and value of any payment between donors and recipients is likely to be small. We conclude that most donors and recipients have similar modest incomes, suggesting that the costs of donation are a significant burden in the majority of living donor transplants.

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    ABSTRACT: Hispanics are disproportionately affected by renal failure. Although living donation has been heralded as a potential means for alleviating the need for transplantable kidneys, a nuanced understanding of the obstacles faced by Hispanics is necessary. In our study, we conducted focus groups with 28 first-generation Spanish-dominant Hispanic renal patients. Although some of the barriers that emerged were akin to those reported in previous research (e.g., a lack of knowledge about the process), others were unique. Rarely chronicled barriers include the disqualification of family members because of medical issues, potential donors being unable to miss work, disqualification of family members who are undocumented, concern that potential donors cannot support their family if they donate, and declining social support because of illness. The interaction among this constellation of barriers makes living donation particularly difficult among this population. Investigations focused on the unique barriers faced by these low-resource individuals are warranted.
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