Economic Consequences of Adult Living Kidney Donation: A Systematic Review.
Fu, R., et al.Value in Health 2021; 24(4): 592-601.
Aims
This study aimed to evaluate the magnitude and type of cost that adult living kidney donors have to incur.
Interventions
A literature search was conducted using the UK National Institute for Health Research Economic Evaluation Database, MEDLINE, PubMed, Scopus, Research Papers in Economics, and EconLit. Study selection and data extraction were performed by two reveiwers. The methodological quality of the included studies was assessed by one reviewer, using the the Joanna Briggs Institute appraisal checklists.
Participants
16 studies were included in the review.
Outcomes
The primary outcome was total donor-borne costs. The secondary outcomes were types of costs and donation-related financial correlates.
Follow-up
N/A
CET Conclusions
The narrative systematic review aimed to assess the donor costs for adult living kidney donors. A comprehensive search identified 16 studies mostly published since 2005 that came from North America. Two reviewers independently selected studies for inclusion and extracted data. One reviewer assessed the risk of bias using the appraisal checklists from the Joanna Briggs Institute and found that most (13/16) studies had low risks of bias. The review included pre-, peri- and post-donation costs incurred by the donor and their caregivers. The average donor would incur a cost between $900 and $19,900 from pre-donation evaluation to the first posttransplant year. Eleven out of 16 studies presented direct, out-of-pocket expenses related to travel, accommodation and health services. All studies reported indirect costs, such as lost income, lost home productivity and new costs including lost income for the donor caregiver and insurance difficulties. Most costs were uncompensated. Donor-perceived financial burden was higher among donors from lower-income households and those who travelled greater distances.
Trial registration
N/A