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Best practices to optimize utilization of the National Living Donor Assistance Center for the financial assistance of living organ donors
Authors:Amit K Mathur  Zoe A Stewart Lewis  Patricia H Warren  Marie‐Claire Walters  Kimberly A Gifford  Jiawei Xing  Nathan P Goodrich  Renee Bennett  Ada Brownson  Jill Ellefson  Gerardo Felan  Barrett Gray  Rebecca E Hays  Cathy Klein‐Glover  Shelley Lagreco  Nancy Metzler  Kimberly Provencher  Emily Walz  Kara Warmke  Robert M Merion  Akinlolu O Ojo
Abstract:Living organ donors face direct costs when donating an organ, including transportation, lodging, meals, and lost wages. For those most in need, the National Living Donor Assistance Center (NLDAC) provides reimbursement to defray travel and subsistence costs associated with living donor evaluation, surgery, and follow‐up. While this program currently supports 9% of all US living donors, there is tremendous variability in its utilization across US transplant centers, which may limit patient access to living donor transplantation. Based on feedback from the transplant community, NLDAC convened a Best Practices Workshop on August 2, 2018, in Arlington, VA, to identify strategies to optimize transplant program utilization of this valuable resource. Attendees included team members from transplant centers that are high NLDAC users; the NLDAC program team; and Advisory Group members. After a robust review of NLDAC data and engagement in group discussions, the workgroup identified concrete best practices for administrative and transplant center leadership involvement; for individuals filing NLDAC applications at transplant centers; and to improve patient education about potential financial barriers to living organ donation. Multiple opportunities were identified for intervention to increase transplant programs’ NLDAC utilization and reduce financial burdens inhibiting expansion of living donor transplantation in the United States.
Keywords:donors and donation: living  ethics and public policy  kidney disease  kidney transplantation/nephrology  patient education  transplant coordinator  transplant social worker
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