{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:28:58Z","timestamp":1747186138009,"version":"3.40.5"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T00:00:00Z","timestamp":1695859200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Since non\u2010directed (altruistic) kidney donors do not stand to benefit from the lengthening and strengthening of a relationship that they intrinsically value, their donations are considered to constitute the most altruistic variety of living kidney donation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methodology<\/jats:title><jats:p>This paper uses publicly\u2010available data to assess the expected value that accrues to the donor of altruistic kidney donation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Compared to healthy non\u2010donors, living kidney donors experience only marginally increased absolute risks of poor physical health outcomes, and no difference in important psychosocial health outcomes. Crucially, the chance of requiring a kidney donation is only marginally increased by becoming a living kidney donor. In the United Kingdom, previous living kidney donors that subsequently become in need of any organ donation (not only kidneys) themselves are considered priority patients for these donations. They consequently experience shorter waiting times for these organs and reduced exposure to the inherently harmful effects of dialysis therapy (if a kidney donation is required) compared to non\u2010donors in need of organ donation. As such, while key data points required to compute an accurate and complete expected value calculation are unavailable, it is likely that the additional risk incurred by becoming a living kidney donor is outweighed by the benefit of being considered a priority patient for the donation of any type of organ in the event that this is needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Accordingly, the expected value of becoming a living kidney donor is likely to be positive, meaning the act of doing so may be considered akin to the taking out of an insurance policy. In the context of non\u2010directed (altruistic) kidney donation, this may diminish the extent to which such a donation is considered altruistic.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.13929","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T05:02:30Z","timestamp":1695963750000},"page":"780-785","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Non\u2010directed (altruistic) kidney donation: Altruism or insurance policy?"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1165-6753","authenticated-orcid":false,"given":"Richard C.","family":"Armitage","sequence":"first","affiliation":[{"name":"Academic Unit of Population and Lifespan Sciences School of Medicine, University of Nottingham Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,28]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"NHS Blood and Transplant. POL274\/7\u2014Living Donor Kidney Transplantation.2023. Accessed June 26 2023.https:\/\/nhsbtdbe.blob.core.windows.net\/umbraco-assets-corp\/29558\/pol274.pdf"},{"key":"e_1_2_9_3_1","unstructured":"Human Tissue Authority. Living organ donation. Accessed June 26 2023.https:\/\/www.hta.gov.uk\/guidance-public\/body-organ-and-tissue-donation\/living-organ-donation"},{"key":"e_1_2_9_4_1","unstructured":"Human Tissue Act.2004. Accessed June 26 2023.https:\/\/www.legislation.gov.uk\/ukpga\/2004\/30\/pdfs\/ukpga_20040030_en.pdf"},{"key":"e_1_2_9_5_1","unstructured":"Human Tissue (Scotland) Act.2006. Accessed June 26 2023.https:\/\/www.legislation.gov.uk\/asp\/2006\/4\/pdfs\/asp_20060004_en.pdf"},{"key":"e_1_2_9_6_1","unstructured":"NHS Blood and Transplant. 2023.UK Living Kidney Sharing Scheme. Accessed June 26 2023.https:\/\/www.odt.nhs.uk\/living-donation\/uk-living-kidney-sharing-scheme"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/medethics-2018-104817"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/jme.2006.017939"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/medethics-2012-100528"},{"key":"e_1_2_9_10_1","unstructured":"NagelT.The Possibility of Altruism.Oxford University Press 1970."},{"volume-title":"Friendship, Altruism and Morality","year":"1980","author":"Blum L","key":"e_1_2_9_11_1"},{"volume-title":"Human Bodies: Donation for Medicine and Research","year":"2011","author":"Nuffield Council on Bioethics","key":"e_1_2_9_12_1"},{"key":"e_1_2_9_13_1","unstructured":"NHS Blood and Transplant. ODT Clinical.Patient (Potential Donor) Assessment. Accessed June 27 2023.https:\/\/www.odt.nhs.uk\/odt-structures-and-standards\/organ-donation-retrieval-and-transplantation-teams\/patient-potential-donor-assessment\/"},{"key":"e_1_2_9_14_1","unstructured":"British Transplantation Society. Guidelines for Living Donor Kidney Transplantation. 4th ed. March 2018 Accessed June 27 2023.https:\/\/bts.org.uk\/wp-content\/uploads\/2018\/07\/FINAL_LDKT-guidelines_June-2018.pdf"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.237"},{"key":"e_1_2_9_16_1","unstructured":"Sustainable Development Goals UK.Indicator 3.1.1\u2014Maternal mortality ratio. Accessed June 27 2023.https:\/\/sdgdata.gov.uk\/3-1-1\/"},{"key":"e_1_2_9_17_1","unstructured":"St George's University Hospitals NHS Foundation Trust.Laparoscopic donor nephrectomy aftercare.2021. Accessed June 27 2023.https:\/\/www.stgeorges.nhs.uk\/wp-content\/uploads\/2021\/07\/REN_LDNA_02.pdf"},{"key":"e_1_2_9_18_1","unstructured":"Give A Kindye.How safe is donation?Accessed June 27 2023.https:\/\/www.giveakidney.org\/how-safe-is-donation\/"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.17209"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2013.460"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016490"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14678"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14618"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2006.01567.x"},{"key":"e_1_2_9_25_1","unstructured":"NHS Blood and Transplant. POL186\/15\u2014Kidney Transplantation: Deceased Donor Organ Allocation.2023. Accessed June 28 2023.https:\/\/nhsbtdbe.blob.core.windows.net\/umbraco-assets-corp\/29322\/pol186.pdf"},{"key":"e_1_2_9_26_1","unstructured":"NHS Blood and Transplant.Organ and tissue donation and transplantation activity report 2021\/22: Kidney activity (Table 5.4). Accessed June 28 2023.https:\/\/nhsbtdbe.blob.core.windows.net\/umbraco-assets-corp\/27118\/section-5-kidney-activity.pdf"},{"key":"e_1_2_9_27_1","unstructured":"NHS Blood and Transplant.How does the offering system work? Learn how kidneys from deceased donors are offered to patients. Accessed June 28 2023.https:\/\/www.nhsbt.nhs.uk\/organ-transplantation\/kidney\/receiving-a-kidney\/how-does-the-offering-system-work\/"},{"key":"e_1_2_9_28_1","unstructured":"Kidney Care UK.Haemodialysis. Accessed June 28 2023.https:\/\/www.kidneycareuk.org\/about-kidney-health\/treatments\/dialysis\/haemodialysis\/"},{"key":"e_1_2_9_29_1","unstructured":"Kidney Care UK.Peritoneal dialysis. Accessed June 28 2023.https:\/\/www.kidneycareuk.org\/about-kidney-health\/treatments\/dialysis\/peritonealdialysis\/"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.5772\/36832"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/16.7.1387"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(97)90342-5"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.2307\/1909829"},{"volume-title":"Theory of Games and Economic Behavior","year":"2004","author":"Neumann J","key":"e_1_2_9_34_1"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-020145"}],"container-title":["Journal of Evaluation in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.13929","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T17:35:55Z","timestamp":1722447355000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jep.13929"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,28]]},"references-count":34,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1111\/jep.13929"],"URL":"https:\/\/doi.org\/10.1111\/jep.13929","archive":["Portico"],"relation":{},"ISSN":["1356-1294","1365-2753"],"issn-type":[{"type":"print","value":"1356-1294"},{"type":"electronic","value":"1365-2753"}],"subject":[],"published":{"date-parts":[[2023,9,28]]},"assertion":[{"value":"2023-06-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}