@article{7aa14fb9adc249f5afaa450b596bd6cd,
title = "Return on investment for financial assistance for living kidney donors in the United States",
abstract = "Background: The National Living Donor Assistance Center (NLDAC) enables living donor kidney transplants through financial assistance of living donors, but its return on investment (ROI) through savings on dialysis costs remains unknown. Methods: We retrospectively reviewed 2012-2015 data from NLDAC, the United States Renal Data System, and the Scientific Registry of Transplant Recipients to construct 1-, 3-, and 5-year ROI models based on NLDAC applications and national dialysis and transplant cost data. ROI was defined as state-specific federal dialysis cost minus (NLDAC program costs plus state-specific transplant cost), adjusted for median waiting time (WT). Results: A total of 2425 NLDAC applications were approved, and NLDAC costs were USD $6.76 million. Median donor age was 41 years, 66.1% were female, and median income was $33 759; 43.6% were evaluated at centers with WT >72 months. Median dialysis cost/patient-year was $81 485 (IQR $74 489-$89 802). Median kidney transplant cost/patient-year was $30 101 (IQR $26 832-$33 916). Overall, ROI varied from 5.1-fold (1-year) to 28.2-fold (5-year), resulting in $256 million in savings. Higher ROI was significantly associated with high WT, larger dialysis and transplant costs differences, and more NLDAC applicants completing the donation process. Conclusions: Financial support for donor out-of-pocket expenses produces dramatic federal savings through incremental living donor kidney transplants.",
keywords = "financial support, kidney transplantation, living donor",
author = "Mathur, {Amit K.} and Jiawei Xing and Dickinson, {David M.} and Warren, {Patricia H.} and Gifford, {Kimberly A.} and Hong, {Barry A.} and Akinlolu Ojo and Merion, {Robert M.}",
note = "Funding Information: Funding information Financial support: U13 HS07689-09-01. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. This publication/presentation was supported by Grant No. U13HS030586 from the U.S. Department of Health and Human Services, Health Resources and Services Administration's Division of Transplantation (HRSA/DoT). The contents of this publication/presentation are solely the responsibility of the author(s) and do not necessarily represent the views of HRSA/DoT. The contents of this publication/presentation are solely the responsibility of the author(s) and do not necessarily represent the views of HRSA/DoT. Funding Information: Return on investment for financial assistance for living kidney donors in the United States Funding Information: Financial support: U13 HS07689-09-01. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. This publication/presentation was supported by Grant No. U13HS030586 from the U.S. Department of Health and Human Services, Health Resources and Services Administration{\textquoteright}s Division of Transplantation (HRSA/DoT). The contents of this publication/presentation are solely the responsibility of the author(s) and do not necessarily represent the views of HRSA/DoT. Publisher Copyright: {\textcopyright} 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",
year = "2018",
month = jul,
doi = "10.1111/ctr.13277",
language = "English (US)",
volume = "32",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",
number = "7",
}