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Challenges, Innovations, and Next Steps in Achieving Financial Neutrality for Living Donors

  • Live Kidney Donation (K Lentine and R Schaffer, Section Editors)
  • Published:
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Abstract

Purpose of Review

Recent national attention on living kidney donation brings renewed focus on policy related to alleviating financial burdens for donors, reducing out-of-pocket expenses incurred in the donation process, and optimizing follow-up care. This review examines the Advancing American Kidney Health Executive Order and its potential to improve financial neutrality for living organ donors.

Recent Findings

Available research, including single and multi-center studies, demonstrate that living donors face financial burdens in the donation process, which may be decreased by covering lost wages and expenses related to dependent care. Drawing from these findings, recent consensus statements and subsequent federal guidance proposed interventions to reduce financial barriers for living donors.

Summary

Policy efforts to improve financial neutrality for living donors can help remove disincentives to donation and facilitate more living donor transplantations. The outcome of policy changes should be monitored to determine impact and identify further areas of attention, including increasing reimbursement caps and liberalizing donor and recipient income limits.

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Notes

  1. Based on Lost Wages Demonstration Project—pilot program run by NLDAC, prior to current proposed rule changes. Covers organ donation through January 31, 2022, only at limited centers participating in pilot. Reimbursement cap in proposed broader program may be increased from those used in pilot to account for reimbursement of child- and elder-care in addition to wages.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. American Living Organ Donor Fund (ALODF), Philadelphia, PA, USA

    Michael Mittelman, Rebecca Bertha & Ken Sutha

  2. Division of Nephrology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA

    Ken Sutha

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  1. Michael Mittelman
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  2. Rebecca Bertha
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Correspondence to Michael Mittelman.

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Conflict of Interest

Michael Mittelman, Rebecca Bertha, and Ken Sutha are board members for the American Living Organ Donor Fund. MM is founder and president. RB manages applications for grant assistance.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Live Kidney Donation

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Mittelman, M., Bertha, R. & Sutha, K. Challenges, Innovations, and Next Steps in Achieving Financial Neutrality for Living Donors. Curr Transpl Rep 7, 215–222 (2020). https://doi.org/10.1007/s40472-020-00291-1

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