We all deserve access to quality kidney care, regardless of the state we live in.   

For people living with kidney failure, a kidney transplant is the best treatment currently available. Everyone who needs a transplant should be able to get one; unfortunately, there are not enough organs available, which means that many people with kidney failure must wait years for a transplant from a deceased donor. During that wait time, they may become too sick to receive a transplant or even die before a kidney is available. 

However, deceased donor transplants are not the only option for people with kidney failure, as patients can also receive kidneys from living donors. Living donor transplants generally present fewer complications and typically function longer than deceased donor organs, and they increase the existing organ supply, which ensures more deceased organs are available to people on the transplant waitlist.  Enacting legislation that supports living donors in their decision and removes barriers they may face is essential to increasing the number of living donors.   

Since 2021, the American Kidney Fund (AKF) has graded each of the 50 states and the District of Columbia on how well their laws encourage living organ donation and reduce barriers for living donors.   

Increasing living donor protections has been a key part of AKF’s policy agenda, and our sixth annual Living Donor Protection Report Card shows progress made in 2025. The District of Columbia, Maryland and Rhode Island all passed new laws last year that provide protections or financial support for living organ donors. In total, 38 states and the District of Columbia have laws in place protecting living donors from insurance discrimination. Since AKF’s Living Donor Protection Report Card was first released, 28 states and the District of Columbia have enacted laws that support living organ donors, such as those that provide tax credits, paid leave or protect against discrimination by insurers.   

AKF is continuing its efforts alongside AKF Ambassadors across the country to urge states to pass more laws that will encourage and support people to become living donors. On the federal side, we are encouraged by the Senate Health, Education, Labor and Pensions committee favorably reporting the Living Donor Protection Act out of committee earlier this year, and we urge Congress to swiftly pass this legislation in both the Senate and the House of Representatives. The Living Donor Protection Act would provide baseline protections nationwide, ensuring that living organ donors have Family and Medical Leave Act and anti-discrimination protections. Passage of such legislation would mean that the lowest Report Card grade any state could receive would be a C.

Read our press release here.