Dollars for donors: Many support financial incentives to encourage organ donation

Most Canadians view financial incentives for deceased kidney donation to be acceptable, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN). Nearly half of the general public in Canada also find it acceptable for living kidney donation. Studies are now needed to determine whether acceptability of financial incentives translates to more available organs to patients in critical need of a transplant.

Kidney transplantation is the best treatment for patients with kidney failure. Unfortunately, there's a shortage of kidneys available to those in need of a transplant, and donation rates from both living and deceased donors have remained relatively unchanged over the last decade.

Lianne Barnieh, PhD, Braden Manns, MD (University of Calgary, in Canada) and their colleagues looked to see whether financial incentives to increase donation are acceptable and whether they would change individuals' willingness to consider donation. To accomplish this, they administered a questionnaire in the fall of 2011 to 2,004 members of the Canadian public, 339 health professionals, and 268 people with or affected by kidney disease.

Among the major findings:

• 70% and 40% of respondents found financial incentives to be acceptable for deceased and living donors, respectively.
• 45%, 14%, and 27% of the public, health professionals, and people with or affected by kidney disease, respectively, supported monetary payment as a financial incentive for living donors.
• Overall, reimbursement of funeral expenses for deceased donors and a tax break for living donors were the most acceptable forms of financial incentives.

The authors also examined people's differences in opinion based on household income. "We did not find evidence that those with lower income would be more likely to donate for financial gain. Though it is not possible to determine through a questionnaire whether a system of financial incentives would exploit those with lower income, the results in our questionnaire did not show any evidence of this," said Dr. Barnieh.

Future research should examine whether financial incentives might increase donations from deceased and living kidney donors.