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

[Clark]

http://onlinelibrary.wiley.com/doi/10.1111/ajt.13591/abstract

Original Article
Direct and Indirect Costs Following Living Kidney Donation: Findings From the KDOC Study
      J. R. Rodrigue1,2,*, J. D. Schold3, P. Morrissey4, J. Whiting5, J. Vella5, L. K. Kayler6,7, D. Katz8, J. Jones8, B. Kaplan9,10, A. Fleishman1, M. Pavlakis1,2, D. A. Mandelbrot1,11 andfor the KDOC Study Group
Article first published online: 4 FEB 2016
DOI: 10.1111/ajt.13591
American Journal of Transplantation
Early View (Online Version of Record published before inclusion in an issue)

Abstract
Some living kidney donors (LKDs) incur costs associated with donation, although these costs are not well characterized in the United States. We collected cost data in the 12 mo following donation from 182 LKDs participating in the multicenter prospective Kidney Donor Outcomes Cohort (KDOC) Study. Most LKDs (n = 167, 92%) had one direct cost or more following donation, including ground transportation (86%), health care (41%), meals (53%), medications (36%), lodging (23%), and air transportation (12%). LKDs missed 33 072 total work hours, 40% of which were unpaid and led to $302 175 in lost wages (mean $1660). Caregivers lost $68 655 in wages (mean $377). Although some donors received financial assistance, 89% had a net financial loss in the 12-mo period, with one-third (33%) reporting a loss exceeding $2500. Financial burden was higher for those with greater travel distance to the transplant center (Spearman's ρ = 0.26, p < 0.001), lower household income (Spearman's ρ = −0.25, p < 0.001), and more unpaid work hours missed (Spearman's ρ = 0.52, p < 0.001). Achieving financial neutrality for LKDs must be an immediate priority for the transplant community, governmental agencies, insurance companies, nonprofit organizations, and society at large.