Proposal responds to the first decline this century in kidney transplants driven by falling deceased donor availability

Living Donor Facilitator Training Programs will help patients identify donors, support them through the process, and increase transplants while reducing Medicare spending

WASHINGTON, D.C. – [March 18, 2026] — In light of the first annual decline this century in U.S. kidney transplants driven by a drop in deceased donor organs, the Kidney Transplant Collaborative (KTC) today released a new congressional briefing outlining how living donor facilitator training programs at transplant centers could dramatically expand living kidney donation in the United States. 

More than 94,000 Americans are currently waiting for a kidney transplant, yet the number of available organs continues to fall short of demand. The shortage worsened in 2025 when the United States experienced the first annual decline this century in total kidney transplants due to a drop in deceased donor kidney donations. More information can be found in KTC’s full report HERE. 

While deceased donation remains vital, experts increasingly recognize that living kidney donation represents the most scalable path to immediately expanding transplant access and improving outcomes for patients with kidney failure. 

Surveys show that Americans are overwhelmingly willing to consider living kidney donation. A national survey published in Kidney Medicine found that nearly 87 percent of adults said they would consider becoming a living kidney donor. However, research shows that many potential donors drop out during the complex medical evaluation process due to logistical barriers, lack of guidance, or difficulty navigating the system.

“Living kidney donation is one of the most powerful tools we have to save lives, yet our system does far too little to help willing donors and patients connect and navigate the transplant process,” said Dr. Andy Howard, Executive Director of the Kidney Transplant Collaborative. “Training living donor facilitators at transplant hospitals would give patients and donors the support they need to identify potential donors and successfully navigate the transplant process. With the right support, we can dramatically increase the number of lifesaving transplants.”

Evidence from leading transplant programs demonstrates that structured donor facilitation programs and training can significantly increase living donor transplants. Programs at institutions such as Johns Hopkins and the University of Alabama at Birmingham have shown that trained facilitators who help recipients identify potential donors and assist donors through evaluation can dramatically increase successful living donation.

The briefing outlines how transplant hospitals could establish living donor facilitator training programs to support patients and potential donors throughout the transplant process. Congress could support these programs by clarifying that facilitator training costs are eligible for reimbursement through existing Medicare hospital cost reporting rules and unlock a scalable national strategy to expand living donation.

Expanding living kidney transplantation would also produce significant savings for taxpayers. Analysts estimate that each kidney transplant saves Medicare approximately $800,000 over ten years by reducing reliance on dialysis and other costly treatments. Doubling the number of living donor transplants could reduce Medicare spending by billions while improving survival and quality of life for thousands of patients.

KTC’s briefing outlines how the proposed facilitator training model could help increase living donor kidney transplants from roughly 6,500 per year today to as many as 12,000 to 13,000 annually, potentially doubling living donation nationwide.

Following the recent decline in deceased donor kidney transplants, KTC is urging policymakers to support national living donor facilitator training programs in order to expand transplant access, improve patient outcomes, and reduce Medicare spending.

About the Kidney Transplant Collaborative

The Kidney Transplant Collaborative (KTC) is a 501(c)(4) nonprofit organization dedicated to increasing kidney transplants and removing financial and logistical barriers for kidney patients, donors, and their families. Unlike other initiatives, KTC is specifically focused on increasing the number of living donor transplants in the United States through policy advocacy, education, and community organizing. For more details, visit www.kidneytransplantcollaborative.com.