Living donor financial assistance programs in liver transplantation: The global perspective |
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| Authors: | Juliet Emamaullee Lisa Tenorio Sara Khan Chante Butler Susan Kim Reginald Tucker-Seeley Yong Kwon James Shapiro Sanjiv Saigal Linda Sher Yuri Genyk |
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| Affiliation: | 1. Division of Hepatobiliary and Abdominal Organ Transplant Surgery, University of Southern California, Los Angeles, California, USA;2. School of Medicine, St. Louis University, St. Louis, Missouri, USA;3. Keck School of Medicine, University of Southern California, Los Angeles, California, USA;4. University of Southern California Transplant Institute, Los Angeles, California, USA;5. Davis School of Gerontology, University of Southern California, Los Angeles, California, USA;6. Division of Hepatobiliary and Abdominal Organ Transplant Surgery, University of Southern California, Los Angeles, California, USA Keck School of Medicine, University of Southern California, Los Angeles, California, USA;7. Department of Surgery, University of Alberta, Edmonton, Alberta, Canada;8. Medanta The Medicity, Gurgaon, India |
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| Abstract: | Living donor liver transplantation (LDLT) has increased availability of liver transplantation, particularly in countries with limited access to deceased organ donors. It is unclear how individual countries address the financial impact of donation for potential living donors. Herein, living liver donor financial supports were examined, focusing on countries performing ≥10 LDLT per year in the World Health Organization Transplant Observatory. Categories included health insurance coverage, reimbursement of lost wages, employment protection, and other incentives designed to promote living liver donation. Overall, 26 countries have some form of asssistance in removing disincentives to ease the financial burden of living donation, ranging from childcare, accommodations, meals, and travel reimbursement, to coverage of medical complications post-donation. Most countries provide donation-related medical coverage. Fourteen provide reimbursement of lost wages and/or paid time off. Several unique programs were designed to incentivize living donation, including free entry to museums and observatories, parking and airline discounts, and exemptions on mortgages and medical deductibles. This study highlights the broad range of programs designed to support living liver donation in high-volume LDLT countries. The data collected in this study can provide a framework for other nations to propose and implement ethical reimbursement and incentivization for living liver donors. |
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| Keywords: | living donor incentivization living donor reimbursement living donor liver transplant comprehensive review |
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