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Original Investigation |

Views of US Voters on Compensating Living Kidney Donors

Thomas G. Peters, MD1,2; Jonathan S. Fisher, MD3; Robert G. Gish, MD2,4; Richard J. Howard, MD, PhD5
[+] Author Affiliations
1University of Florida College of Medicine, Jacksonville
2FAIR Foundation, Palm Desert, California
3Scripps Center for Organ Transplantation, La Jolla, California
4Liver Transplant Program, Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Stanford, California
5LifeQuest Organ Recovery Services, Gainesville, Florida
JAMA Surg. 2016;151(8):710-716. doi:10.1001/jamasurg.2016.0065.
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Importance  Patients in the United States waiting for kidney transplantation die in increasing numbers owing to the severe kidney shortage, which might be alleviated by compensating living kidney donors.

Objective  To determine the willingness of voting US citizens to become living kidney donors and to ascertain the potential influence of compensation for donation.

Design, Setting, and Participants  A professionally designed quantitative survey was administered by an international polling firm in June 2014. Information was collected on willingness to donate a kidney and the potential influence of compensation ($50 000); survey data included respondent age, income, education level, sex, US region, race/ethnicity, marital status, political affiliation, likelihood to vote, and employment status. The survey was performed via a random-digit dialing process that selected respondents via both landlines and mobile telephones to improve population representation. The survey included 1011 registered US voters likely to vote.

Main Outcomes and Measures  The degree to which the US voting public is willing to donate a kidney and the perceptions of current voters toward paying living kidney donors.

Results  Of the 1011 respondents, 427 were male and 584 were female, with 43% of participants between ages 45 and 64 years. With respondents grouped by willingness to donate, we found that 689 (68%) would donate a kidney to anyone and 235 (23%) only to certain persons; 87 (9%) would not donate. Most (59%) indicated that payment of $50 000 would make them even more likely to donate a kidney, 32% were unmoved by compensation, and 9% were negatively influenced by payment.

Conclusions and Relevance  Most US voters view living kidney donation positively, and most would be motivated toward donor nephrectomy if offered a payment of $50 000. Because most registered voters favor such payments, and because thousands of lives might be saved should compensation increase the number of transplantable kidneys, laws and regulations prohibiting donor compensation should be modified to allow pilot studies of financial incentives for living kidney donors. Outcomes of such trials could then result in evidence-based policies, which would incorporate fair and just compensation to those persons willing to undergo donor nephrectomy.

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Figure 1.
US Kidney Transplant Waiting List Trends, 2004 to 2013
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Figure 2.
Willingness to Donate a Kidney
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