'Because you can't live on love': living kidney donors' perspectives on compensation and payment for organ donation

Rhonda M. Shaw*, Lara J. M. Bell

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)


Context and objective Living kidney donation accounts for approximately half of all kidney transplantation in many countries and is central to health policy focused on increasing organ supply. However, little examination of the economic consequences of living kidney donation has been undertaken from the perspective of donors themselves. This article documents living kidney donors' views regarding recompense and payment for organ donation, based on their experience.

Participants Twenty-five living kidney donors from New Zealand participated in this study.

Methods This qualitative study, based on thematic analysis, uses semi-structured in-depth interviews to examine the experiences of living kidney donors. Themes were organized around altruism and the 'gift', perceptions of shared corporeality and identity, and donor support.

Results Most participants agreed the donation process was costly in terms of time and money. Many incurred personal costs, and some experienced financial hardship. All the participants viewed financial hardship as a barrier to organ donation and favoured recompense for direct and indirect costs. Most did not support payment for organs, and none supported commercialization.

Discussion and conclusions The findings show that framing organ donation as a 'gift' can stymie discussion about reciprocity, remuneration and exchange, making talk about financial recompense difficult. Financial well-being, nonetheless, has implications for the ability to care for self and others post-operatively. We conclude that the economic consequences for living kidney donors in jurisdictions where recompense for direct and indirect costs is insufficient are unfair. Review of financial assistance for live organ donors is therefore recommended.

Original languageEnglish
Pages (from-to)3201-3212
Number of pages12
JournalHealth Expectations
Issue number6
Publication statusPublished - Dec 2015
Externally publishedYes


  • financial recompense
  • gift of life
  • live kidney donation
  • New Zealand
  • payment


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