Living donor kidney transplantation is the optimal treatment for most patients with kidney failure, enabling improved length and quality of life in comparison to dialysis or deceased donor transplantation.1 The procedure is also unique among medical interventions in being not only cost-effective, but also cost-saving for the health care system.1 Although widely accepted that giving the gift of organ donation should be a financially neutral act for the donor, donation-related financial risks remain a reality within the structure of current practice and policies.