Concern for Lost Income Following Donation Deters Some Patients From Talking to Potential Living Donors

Abstract

Context: Some living kidney donors report lost income during recovery from surgery. Little is known about whether concern for living donor’s lost income affects the decision to undergo donation evaluation and the willingness of transplant candidates to discuss living kidney donation (LKD) with others. Objective: To examine whether transplant patients were told by potential donors about lost income concerns and whether patients chose not to discuss LKD with others due to lost income concerns. Design, Setting, and Patients: Kidney transplant patients (185 wait-listed candidates, 171 deceased donor recipients, and 100 live donor recipients) at 2 centers completed a questionnaire to assess whether concern about donor’s lost income was a consideration in discussion about LKD with others. Results: One-third (32%) were told by a family member/friend that they were willing to donate but were concerned about potential lost income. The majority of those who expressed financial concern (64%) did not initiate donation evaluation. Many patients (42%) chose not to discuss living donation with a family member/friend due to concern about the impact of lost income on the donor. In the multivariable model, lower annual household income was the only statistically significant predictor of both having a potential donor expressing lost income concern and choosing not to talk to someone because of lost income concern. Conclusion: Findings from the current study underscore how concern about income loss for living donors may affect decision-making by both transplant candidates and potential donors.