Directed Kidney Donors Would Consider Kidney Paired Donation

More than 90 percent of directed living kidney donors and recipients would be willing to participate in kidney paired donation (KPD) programs, reports a survey study in Transplantation.

The researchers surveyed 222 directed living kidney donors and their recipients treated at one Canadian center between 2001 and 2009. Respondents were asked whether they would have been willing to participate in KPD programs if that opportunity had been available at the time of their donation. The impact of various types of incentives, monetary and otherwise, was assessed as well.

Eighty-six donors responded to the survey: a rate of 42 percent. Of the responding donors, 93 percent said they would have been willing to participate in a KPD program. Most donors said they would be more willing if offered reimbursement for lost wages and travel. However, cash payments—up to $50,000—had little effect. Donors were also more willing to participate if there was some advantage to the recipient, such as a younger donor or a better HLA match. Willingness decreased with delays longer than 3 months or need for the donor to travel.

The researchers also approached 38 recipients during routine follow-up visits, all of whom participated. Ninety-two percent said they would have been willing to participate in a KPD program.

Kidney paired donation programs are an emerging approach to increase living donor transplantation among patients who have a willing but incompatible donor. If compatible living donors and recipients were to participate, the number of KPD transplants could be doubled.

A large majority of both directed donors and recipients would be willing to participate in KPD programs, the survey suggests. Participation might be increased by reimbursement for costs and increasing the efficiency of KPD, although not by cash incentives. The researchers note, “The finding that compatible donors and their recipients may be more willing to participate in KPD in exchange for a better kidney highlights the need for education and transparency in order to ensure compatible donors and recipients are adequately informed before engaging in KPD” [Hendren E, et al. Willingness of directed living donors and their recipients to participate in kidney paired donation programs. Transplantation 2015; 99:1894–1899].