Yang RC et al. (2007) Insurability of living organ donors: a systematic review. Am J Transplant 7: 1542–1551

To determine whether living organ donation (of kidneys, or lung or liver tissue) affects insurability, which might impact on the willingness of potential donors to proceed, Yang et al. systematically reviewed data from 23 studies performed in five countries during the period 1972–2006. Analysis of 229 survey responses from US and UK insurance companies found that almost all would provide life or health insurance to living kidney donors. Up to 33% would, however, charge a higher premium for donors or would not cover donation-related health problems. Of 1,188 living kidney donors, up to 11% reported difficulty obtaining or maintaining life, disability or health insurance, although insurance premiums did not increase for at least 96% of the donors.

In five studies encompassing almost 1,000 donors, 11–14% of individuals experienced significant stress or concern about their insurability. Living kidney donors were less likely to reaffirm their decision to donate if their insurance premiums increased (P = 0.0001), and a survey of 524 donors found that 4% regretted their decision. A US telephone survey established, however, that respondents would be willing to donate a kidney to a sibling regardless of whether they themselves had health insurance.

Despite assurances from most insurance providers that they would not discriminate against living kidney donors, a notable proportion of donors were worried about issues of insurability. Addressing this potential barrier to donation could help to improve the poor organ donation rates that currently limit transplantation.