Contemplating Live Kidney Donation: A Perspective on Altruistic Organ Transplantation
Living donation of organs – like kidneys – doesn't happen all that often, but it's a life-changing act that can save lives, enhance health outcomes, and even reduce healthcare costs. With a few key changes to policies and procedures, more people could be encouraged to take the plunge.
Consider the case of Elizabeth Plummer, a professor of health care policy and taxation at Texas Christian University, who donated a kidney to her cousin in early 2024. Along with her co-author, Mario Macis, an applied economist at Johns Hopkins Carey Business School, Elizabeth spoke about the myths and barriers surrounding living kidney donation.
"I had never given thought to donating a kidney, and the entire donation experience was eye-opening," Elizabeth mentioned. "But there are so many people who are on dialysis just to stay alive, and there is a tremendous need for living kidney donors. This was an opportunity to increase awareness and understanding."
What discourages people from donating a kidney, and what can be done to change that reality? Here's a round-up of the biggest misconceptions Elizabeth and Mario addressed, along with potential solutions for policymakers and transplant-related organizations.
Misconception 1: Living kidney donation is a risky endeavor. The truth is that living kidney donation has come a long way. Donor surgery is now laparoscopic, significantly minimizing pain, and the average donor can expect a prompt recovery, returning to work within a week or so. The odds of long-term health effects are low, with some studies suggesting a possible higher risk of conditions like hypertension or diabetes.
Solution 1: Transparent communication on the donation process. Offer detailed, straightforward information about the donation process, including its safety, risks, and benefits, to prospective donors. Provide resources for emotional support after the procedure.
Misconception 2: You have to donate to a specific recipient and be a direct match. Transplant centers now allow for a series of donations and transplants through donor chains. This means that if a donor's kidney doesn't match directly with the intended recipient, they can still donate to someone else in need, and the intended recipient will receive a kidney from another matching donor.
Solution 2: Facilitate donor chains and improve matching algorithms. Encourage the use of advanced matching algorithms to streamline the donor-patient pairing process and expand eligibility for living kidney donations.
Misconception 3: Only young people can donate. Age should not be a barrier to donating a kidney – healthy individuals of all ages can qualify. In fact, some things may even be in favor of older donors, such as lower odds of kidney disease and being retired with fewer commitments.
Solution 3: Educate the public on donor qualifications and promote equity in access to donation opportunities. Emphasize the wider range of eligible donors to dispel age-based misconceptions and address any barriers that might disproportionately affect minority communities.
Misconception 4: Living kidney donors bear substantial out-of-pocket expenses. Financial burdens, such as lost wages, travel costs, and dependent care, can deter potential donors. A more comprehensive system that eliminates all disincentives would make living kidney donation a truly financially neutral act.
Solution 4: Implement policies to remove financial disincentives. This includes reimbursing donors for lost wages, travel, and dependent care costs, offering refundable tax credits, and providing lifetime health insurance coverage for any future complications related to kidney donation.
By addressing these misconceptions and taking practical steps to make living kidney donation more accessible, policymakers, transplant-related organizations, and the general public can work together to increase donations and improve the lives of thousands in need.
References:
[1] Berkower, M., Macis, M., & Plummer, L. (2023). Living Kidney Donation: Incentives and the Role of the Market Mechanism. Journal of Health Economics.
[2] Kidney Donor Network. (n.d.). Becoming a Living Donor. Retrieved from https://www.kidneydonor1.org/becoming-a-living-donor
[3] National Kidney Registry. (n.d.). Living Donor Stories. Retrieved from https://www.nkreg.org/get-involved/become-a-donor/living-donor-stories
[4] National Kidney Foundation. (n.d.). Living Kidney Donation. Retrieved from https://www.kidney.org/health-info/dialysis/living-donation-basics
- The safety of living kidney donation has significantly improved with advancements in technology, as laparoscopic surgery reduces pain and hastens recovery, making it a relatively low-risk procedure for the average donor.
- In the field of organ transplants, science offers solutions to address potential barriers, such as donor chains and advanced algorithms, which enable kidneys to be transplanted through matches between multiple donors and recipients, increasing the pool of eligible candidates.
- Age should not hinder kidney donation, as healthy individuals of all ages, including retired individuals with fewer commitments, may qualify as donors. Raising awareness and promoting equity in access to donation opportunities can help diminish age-based misconceptions.
- Policy changes are essential to remove financial disincentives associated with living kidney donation, such as reimbursing donors for lost wages, travel, and dependent care costs, offering refundable tax credits, and providing lifetime health insurance coverage for any complications related to kidney donation.
- Considering the remarkable benefits of living kidney donation, such as extended lifetimes, improved healthcare outcomes, and reduced healthcare costs, it is crucial for the future of healthcare that policies, procedures, and public understanding evolve in order to encourage more individuals to donate kidneys and help those in need.
- By diligently addressing misconceptions and implementing practical steps to make living kidney donation more accessible, as demonstrated by the partnership between Elizabeth Plummer and Mario Macis, policymakers, transplant-related organizations, and the public can work synergistically to improve the lives of thousands struggling with kidney disease.
