Living Kidney Donors' Financial Expenses and Mental Health

Donor Nephrectomy Outcomes Research (DONOR) Network, Lianne Barnieh, Jennifer B. Arnold, Neil Boudville, Meaghan S. Cuerden, Mary Amanda Dew, Christine Dipchand, Liane S. Feldman, John S. Gill, Martin Karpinski, Scott Klarenbach, Greg Knoll, Charmaine Lok, Matt Miller, Mauricio Monroy, Chris Nguan, G. V.Ramesh Prasad, Jessica M. Sontrop, Leroy Storsley, Amit X. Garg

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


BACKGROUND: Living kidney donors incur donation-related expenses, but how these expenses impact postdonation mental health is unknown. METHODS: In this prospective cohort study, the association between mental health and donor-incurred expenses (both out-of-pocket costs and lost wages) was examined in 821 people who donated a kidney at one of the 12 transplant centers in Canada between 2009 and 2014. Mental health was measured by the RAND Short Form-36 Health Survey along with Beck Anxiety Inventory and Beck Depression Inventory. RESULTS: A total of 209 donors (25%) reported expenses of >5500 Canadian dollars. Compared with donors who incurred lower expenses, those who incurred higher expenses demonstrated significantly worse mental health-related quality of life 3 months after donation, with a trend towards worse anxiety and depression, after controlling for predonation mental health-related quality of life and other risk factors for psychological distress. Between-group differences for donors with lower and higher expenses on these measures were no longer significant 12 months after donation. CONCLUSIONS: Living kidney donor transplant programs should ensure that adequate psychosocial support is available to all donors who need it, based on known and unknown risk factors. Efforts to minimize donor-incurred expenses and to better support the mental well-being of donors need to continue. Further research is needed to investigate the effect of donor reimbursement programs, which mitigate donor expenses, on postdonation mental health.

Original languageEnglish
Pages (from-to)1356-1364
Number of pages9
Issue number6
Publication statusPublished - 1 Jun 2021


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