Journal
AMERICAN JOURNAL OF TRANSPLANTATION
Volume 17, Issue 4, Pages 1081-1096Publisher
ELSEVIER SCIENCE INC
DOI: 10.1111/ajt.14055
Keywords
basic (laboratory) research; science; liver transplantation; hepatology; donors and donation: living; donors and donation: donor follow-up; income; liver transplantation: living donor
Categories
Funding
- National Institute of Diabetes & Digestive & Kidney Diseases [U01-DK62444, U01-DK62467, U01-DK62483, U01-DK62494, U01-DK62498, U01-DK62531, U01-DK62536, U01-DK85515, U01-DK85563, U01-DK85587]
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Because results from single-center (mostly kidney) donor studies demonstrate interpersonal relationship and financial strains for some donors, we conducted a liver donor study involving nine centers within the Adult-to-Adult Living Donor Liver Transplantation Cohort Study 2 (A2ALL-2) consortium. Among other initiatives, A2ALL-2 examined the nature of these outcomes following donation. Using validated measures, donors were prospectively surveyed before donation and at 3, 6, 12, and 24 mo after donation. Repeated-measures regression models were used to examine social relationship and financial outcomes over time and to identify relevant predictors. Of 297 eligible donors, 271 (91%) consented and were interviewed at least once. Relationship changes were positive overall across postdonation time points, with nearly one-third reporting improved donor family and spousal or partner relationships and >50% reporting improved recipient relationships. The majority of donors, however, reported cumulative out-of-pocket medical and nonmedical expenses, which were judged burdensome by 44% of donors. Lower income predicted burdensome donation costs. Those who anticipated financial concerns and who held nonprofessional positions before donation were more likely to experience adverse financial outcomes. These data support the need for initiatives to reduce financial burden.
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