Everyone deserves access to the best kidney care that is available, regardless of where they live or the color of their skin. 

A kidney transplant is the best treatment for kidney failure, offering an opportunity for a longer, healthier life. Yet, due to the severe shortage of donor organs, thousands of people must endure years on the transplant waiting list, with many tragically passing away before ever receiving that life-changing call.

More than 815,000 Americans are living with kidney failure, and nearly 555,000 Americans are on dialysis. Over the past 10 years, the number of people on dialysis who received a kidney transplant increased by 52%, but most of this increase was due to transplants from deceased donors.

There is a way to help: Increase the number of living kidney donors. 

Recent studies have reported that due to advances in surgery and medical care, living organ donation is safer than ever before. Additionally, on average, kidneys from living donors generally have fewer complications than deceased-donor transplants and a longer survival of the donor organ.  

However, lack of awareness, health concerns, job insecurity, insurance discrimination and more deter people from becoming living organ donors. For example, living organ donors typically need 2-12 weeks for surgery and recovery, but not everyone has job-protected leave to take this time to recover after saving a life. In some states, people can also be denied life, disability or long-term care insurance simply because they were a living organ donor, even though research shows people who donate a kidney live as long as similarly healthy people who have both kidneys. 

That’s why at the American Kidney Fund (AKF), we are leading efforts at the state and federal level to advocate for policies to improve living organ donation. We’re calling on both the U.S. House of Representatives and Senate to reintroduce the Living Donor Protection Act. This federal legislation would provide baseline protections nationwide, ensuring that living organ donors have FMLA and anti-discrimination protections. Passage of this legislation would mean that the lowest grade on our State of the States: Living Donor Protection Report Card would be a C. 

This year marks our 5th Annual State of the States: Living Donor Protection Report Card and we are proud of the work that has been done since 2021 to enact legislation in 25 states to support living organ donors. With that said, there is still much more work to be done to ensure comprehensive protections for living donors nationwide. 

Currently, only 6 states have an A grade—meaning they have enacted at least 5 of the 7 types of legislation or regulation that can encourage living donation. More progress is desperately needed. We will continue to fight on all fronts until every state has an A grade. 

To get us there, in 2025 we’re focusing on states across the country with D and F grades that have zero to little protections for living donors. We are working to pass living donor protections in these states and looking at paid and unpaid leave bills in states that have passed living donor protections. This effort includes states where work to improve the number of living organ donors focuses on more rural and medically underserved communities. Simultaneously, we will continue our strong focus on passing the Living Donor Protection Act in Congress.

Without dialysis or a kidney transplant, kidney failure is fatal. We must continue to fight for the 13 Americans on dialysis who die waiting for a kidney transplant every day.

Sincerely,

LaVarne A. Burton

President and Chief Executive Officer

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