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by Kyle J. Lucchese
Aug 25 20231 min read1 answer 1

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Cause prioritizationCommunityKidney donationImpact assessmentPersonal development
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This post is not intended to endorse any particular course of action for one's life, especially if that potentially jeopardizes your health and well-being. Please do your own research and consider how that intersects with your values.

 

I am considering donating a lobe of my liver in a non-directed process and would welcome some community perspective:

  • Is this something you have researched or have done yourself?
  • Do you know anyone who has?
  • What are your thoughts about this from a cost-benefit/impact perspective?
  • A bit of context:
    • I am, by all accounts, healthy and would likely be eligible
    • I am okay with voluntary physical discomfort for others' benefit:
      • I am a regular double-red blood donor 
      • I have already donated a kidney in a non-directed donation
      • I participate in challenge trials when opportunities with high-impact potential become available (I recently participated in a Shigella study and am considering Malaria, Dengue, and Zika options for the fall)

Thank you, in advance, for sharing your perspective!

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ColdButtonIssues

Aug 26, 2023

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Hi Kyle,

If you plan on donating, I think donating through UNOS's pilot program for paired liver donation is the highest impact way for an American to donate lobe currently. 

I would do a BOTEC for how much benefit the recipient would get versus the expected loss of life to you due to surgery risk and long-term effects.

If you are earning to give, I would check out your employer's policy for time off for organ donation as well as the possibility for reimbursement of expenses through NLDAC (which you very well may be familiar with through your kidney experience).

Kyle J. Lucchese8mo1
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Thanks for your comment! The UNOS pairing and BOTEC are great callouts. Fortunately, Johns Hopkins Hospital is a part of the program network. As for the BOTEC: I am going to spend more time researching across sources (including interviews and with the donor team), but finding solid data to factor in has thus far been challenging.

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ColdButtonIssues
8mo
Yes,  I agree it's frustrating. I did a more detailed one when considering living kidney donation. Plus, living liver donation is less common. My fast liver donation BOTEC assumes 80k hours of working hours (reduce if older?). 1 in 250 chance of death (source, maybe too high)= -320 work hours About a month of work lost due to recovery (source)= -160 work hours.  So maybe spending 500 work hours to extend one persons life.  Ignoring time off work due to potential reimbursment, if you netted $15 per hour for the hours lost to risk of death and donated you could probably save a life via AMF. My take is that liver donation probably falls below normal EA effectiveness for most EAs. In contrast, I think kidney donation makes sense for at least some EAs If you think you have stronger obligation to Americans than other people, it might work out. Or if you think your donation could inspire others. It also depends on how impactful you think your job is directly. I will say I really admire liver donors even if it might not clear the bar of cost-effectiveness for many. 
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NickLaing
8mo
Love this BOTEC - thumbs up for more loose BOTECs on the forum. The chance of death is too high to be realistic - better I think to go with the 1000, which brings your BOTEC closer to $2000. I would at least double the earning to $30 on average though, so then $4000.  Either way, like you say hardly slamdunk cost-effective Good job, and it surprises me that this seems so borderline cost effective. Nice one
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Jason
8mo
Although a non-directed donation could potentially enable a significant chain of donations. I think one could count all recipients in the chain if the non-directed donation is a but-for cause of them receiving livers, but would need to include costs to all donors as well.
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ColdButtonIssues
8mo
Good point. I think you would probably only consider the direct costs to those donors (pain/morbidity/risk) and not foregone donations, since presumably the typical liver donor participating in a chain is not devoting a lot of their earnings to impactful charity.
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AnonymousTurtle
8mo
Do you have a link? I'm vaguely considering kidney donation, but haven't found a lot of reliable information on the cost-effectiveness, including opportunity costs. Did you also consider what would be the optimal country to donate a kidney? I expect different countries to have very different needs and donation chain opportunities, so it plausibly makes sense for me to donate a kidney in a different country.
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ColdButtonIssues
8mo
I only am familiar with the US system unfortunately. I think this evaluation holds up pretty well for EAs even though its some years old. 
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Jason8mo7
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Would donating prevent you from other opportunities in the future?

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