University of Michigan Hospital, Ann Arbor, MI, New York University Langone Health, New York, NY.
Department of Surgery, University of Wisconsin, Madison, WI.
Transplant Proc. 2024 Jul-Aug;56(6):1216-1221. doi: 10.1016/j.transproceed.2024.03.040. Epub 2024 Jul 15.
Solid organ transplantation improves the quality of life for patients but has significant out-of-pocket expenses for donors and recipients in the USA, leading many to utilize crowdfunding for donations to cover expenses. We sought to characterize crowdfunding for transplant patients and to identify ethical and policy issues.
We obtained newspaper articles that described crowdfunding campaigns for organ transplant patients from Nexis-Uni. Using Nvivo, we identified and analyzed article details, patient characteristics, features of campaigns, additional fundraisers, and policy and ethical issues related to crowdfunding.
Most sources were published between 2015 and 2020. Of 231 patients identified, 43% were thoracic organ recipients and 42% were kidney recipients. GoFundMe was the most popular platform. 78% of patients reported at least one intended use of crowdfunding; medical expenses were the most cited reason. Ten percent of articles described at least one ethical or policy consideration related to crowdfunding for organ transplant. Concerns included violations of federal laws prohibiting donors from receiving "valuable consideration" for an organ, taxation of funds, loss of Medicaid or disability benefits, accountability for fund usage, and crowdfunding requirements for organ waiting list placement. In several cases, transplants were delayed due to crowdfunding concerns.
Our findings reveal crowdfunding characteristics and financial barriers present among transplant patients. Furthermore, our study suggests that the ethical and policy implications for crowdfunding in the transplant population are not yet adequately assessed. National regulations and transplant center policies may need to be modified to address issues raised by patient crowdfunding.
实体器官移植可提高患者的生活质量，但在美国，捐赠者和受赠者需要承担巨额自付费用，因此许多人利用众筹来为捐赠筹集资金以支付费用。我们旨在描述器官移植患者的众筹情况，并确定其中的伦理和政策问题。
我们从 Nexis-Uni 获取了描述器官移植患者众筹活动的报纸文章。使用 Nvivo，我们确定并分析了文章细节、患者特征、活动特点、其他筹款活动，以及与众筹相关的政策和伦理问题。
大多数来源的发表时间在 2015 年至 2020 年之间。在确定的 231 名患者中，43%为胸部器官受赠者，42%为肾脏受赠者。GoFundMe 是最受欢迎的平台。78%的患者报告至少有一个使用众筹的意图；医疗费用是最常被提及的原因。10%的文章描述了至少一个与器官移植众筹相关的伦理或政策考虑因素。这些问题包括违反联邦法律禁止捐赠者为器官接受“有价值的考虑”、资金征税、丧失医疗补助或残疾福利、对资金使用的问责制，以及众筹对器官等待名单安置的要求。在一些情况下，由于众筹问题，移植被延迟。
我们的发现揭示了移植患者众筹的特点和存在的财务障碍。此外，我们的研究表明，众筹在移植人群中的伦理和政策影响尚未得到充分评估。国家法规和移植中心政策可能需要修改，以解决患者众筹引发的问题。
