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October 17, 2019

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Proven measures could help increase organ donations

There are more than 120,000 people waiting for organs in the United States. More than 100,000 of these individuals need kidneys. Kidneys are unique because most people have two, and it is possible for healthy individuals to donate one to someone in need. But there aren’t enough donated organs for everyone waiting, so clearly changes are needed.

The National Kidney Foundation believes there are effective, proven methods to increase donation and transplantation that are underused, and that addressing those issues would significantly increase the number of kidney transplants.

The NKF believes our community must focus our efforts on expanding proven, safe ways to increase kidney donation and transplantation. We can do so by promoting and expanding opportunities for matched donation on a national level (paired exchange, donor chains).

Years ago, the NKF helped enact legislation in Congress to clarify that paired exchanges do not violate the National Organ Transplant Act, helping to enable more individuals serve as living kidney donors.

We can also cover all costs associated with living donation evaluation and recovery, including lost wages, travel expenses and child care. More than a decade ago, the NKF recommended the establishment of a federal grant program to assist lower-income individuals with travel and subsistence expenses related to donation.

This resulted in the National Living Donor Assistance Program, and thousands of individuals have benefitted from the excellent work it does. We also are pushing for legislative efforts that prohibit life, disability and long-term insurance companies from discriminating against living donors and extend employment protection to donors through the Family Medical Leave Act.

These measures can also reduce the waitlist:

• Increase donation from Expanded Criteria Donors and Donation After Cardiac Death donors to make more organs available for transplant.

• Cover the cost of immunosuppressive drugs for the life of the transplant for kidney recipients whose Medicare coverage ends 36 months post-transplant. If enacted, this legislation will enable recipients to receive immunosuppressive drugs that they are required to take daily to help reduce the likelihood of organ rejection, which reduces the need for multiple transplants. The NKF has worked extensively on this issue, and it is more important than ever as a new study recently found that many insurance plans in the health care exchange marketplace are pushing up the cost of immunosuppressive medications for patients.

• Reduce or eliminate organ discards from deceased donors. Approximately 10,000 kidneys are discarded every four years. Many kidneys are discarded that have an acceptable donor risk index, which means there are undoubtedly quality organs that are discarded but could have been used for transplantation.

The NKF is working with various patient organizations and professional medical societies, collaboratively, on these initiatives and continues to push for legislation and agency actions to address barriers to living donation.

For anyone who is considering organ donation or waiting for a transplant, the National Kidney Foundation has two great resources to help answer questions and provide support.

First, our NKF Peers program matches kidney patients and those considering living donation with someone else who has been through a similar experience. Kidney patients can talk to a trained mentor who has had a kidney transplant, and those who are thinking about living donation can talk to someone who’s already been through the process.

Second, our NKF Cares Help Line offers support for people affected by kidney disease, organ donation or transplantation. Trained professionals are available to answer questions, listen to concerns, and refer people to helpful resources in both English and Spanish. Learn more at

In addition, as a more long-term strategy, the NKF is focused on efforts to increase the early diagnosis of kidney disease in the primary-care setting. This effort may be the best tool we have to reduce the kidney wait list over time. By ensuring proper diagnosis and treatment, we can prevent or delay kidney failure and the need for transplants in the first place.

Jennifer Martin is vice president of Constituent Services for the National Kidney Foundation. She wrote this for

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