In what is being labelled a first, British Columbia is to announce a special reimbursement program today for living donors, some of whom become thousands of dollars poorer after donating a kidney.
The program will be the first in North America to help offset the cost of travelling long distances for medical appointments, losing time off work, or other related expenses when donating an organ.
"The economic consequences to donors has been identified as a bit of a problem as a potential barrier -- you might be essentially scaring off people," Scott Klarenbach, a nephrologist and health economist at the University of Alberta, said in a telephone interview yesterday.
"And that's the last thing we want to do."
Although Dr. Klarenbach is not involved in today's announcement, he has studied the financial barriers living donors face.
In a commentary published in the Canadian Medical Association Journal in March, he advocated a national reimbursement program, saying it is "entirely possible to eliminate the economic risks for Canadian organ donors completely, through legally and ethically acceptable financial reimbursement."
His commentary cited estimates of expenses for living kidney donors in B.C. to range from $1,045 to $5,225.
No funding details of the program, to be announced this morning in Vancouver by the Kidney Foundation of Canada, the British Columbia Transplant Society and a provincial health authority, have been released.
However, some are already calling it a first. One of them is Liberal MP Keith Martin, who has long lobbied for living donors to be able to obtain Employment Insurance benefits in addition to reimbursement of what he called reasonable, out-of-pocket expenses.
Yesterday, in a telephone interview, Dr. Martin said the federal government needs to step up to the plate by providing employment insurance to all living donors.
"They're [living donors] giving of themselves in a way that few people could do and are giving people a lease on life," he said. "Even if you wanted to talk about it economically, it's a very wise investment. It's a matter of basic fairness and humanity."
According to Murray Gross, spokesman for Human Resources and Social Development Canada, live organ donors who have worked 600 hours are eligible for up to $413 a week for a maximum of 15 weeks. No figures are kept on how many live donors have collected EI.
But Dr. Martin said many others, including the self-employed, are not eligible -- and should be.
"A lot of people fall through the cracks," he said.
As provinces watch the number of deceased kidney donors plateau, they are turning their attention to living donors, either those who are biologically or emotionally related to the recipient.
Consequently, the number of living kidney donors has increased and even outstripped the number of deceased donors.
Across Canada, 587 kidneys were obtained from 414 deceased donors in 2005.
Although the number of actual organs harvested is higher in the deceased group because two kidneys can be removed, living donors actually comprise the biggest donor group.
Specifically, 443 living donors gave the same number of kidneys to Canadian recipients last year, said Lilyanna Trpeski, program lead for the Canadian Organ Replacement Register.
In British Columbia, the number of living donors is almost triple that of deceased donors.
In 2005, 74 kidneys were obtained from living donors. That compares with the 41 kidneys that came from 25 deceased donors last year, according to Dr. Trpeski.
Despite the savings to the health-care system in the form of reduced dialysis for recipients, those who donate organs do it at their own financial peril. Typically, the donor is in hospital for a week, and spends another six weeks recuperating from surgery.
Marilyn Shuster of Edmonton certainly knows the costs associated with donating a kidney.
When her son, Edward Shuster, donated his kidney to her five years ago, she said it cost him his job.
"It was a hardship for him. He was in a very high-stress sales position and when he couldn't be there to make his quota, that was it," Ms. Shuster, 63, said in a telephone interview.
"Not all employers are understanding."
Since then, her son found another job -- and she has never felt better.
"I feel wonderful, absolutely wonderful. I had been sick for a lifetime with kidney disease," she said. "Everything worked out really well."
