Whitepaper outlines practical and pragmatic solution to expand living kidney donation while saving billions in Medicare costs

WASHINGTON, D.C. – (April 30, 2025) – The Kidney Transplant Collaborative (KTC) today released a proposal outlining targeted Medicare reforms that would dramatically expand access to living kidney donation while saving billions in Medicare costs. The newly issued whitepaper outlines a bold, detailed proposal to reform the upcoming Medicare Physician Fee Schedule rule to establish a Living Donation Facilitator Program for advanced chronic kidney disease patients and potential living donors.

A key focus of KTC’s leading advocacy efforts, a Living Donation Facilitator Program would include trained facilitators to support patients with advanced chronic kidney disease and their potential donors, guiding them through a complex and often overwhelming transplant process. Clinical research, as explained in the whitepaper, has shown that this kind of support significantly increases the rate of living donor transplants. This is a practical and proven solution that could greatly increase the number of living kidney donors while saving thousands of lives and billions of dollars.

“As a nephrologist with a large kidney transplant practice, I’ve seen firsthand how life-changing a living donor kidney transplant can be. KTC is leading the national effort to make this a reality for more patients by advocating for pragmatic, proven reforms,” said Dr. Andy Howard, MD, FACP, Chair of the Kidney Transplant Collaborative. “We are committed to working with federal policymakers to scale this solution that enables us to save lives and reduce Medicare costs at the same time.”

Living donor transplants offer the best long-term outcomes for patients with End Stage Kidney Disease (ESKD). They also reduce reliance on dialysis, advance health equity, and ease the financial burden on Medicare. Yet despite bipartisan support for value-based care, living donation remains severely underutilized. KTC stands at the forefront of the national movement to change that.

There are currently more than 100,000 Americans waiting for a lifesaving kidney transplant. In 2024 there were approximately 21,000 deceased donor transplants (a 250% increase over 20 years), which was not sufficient to reduce the waitlist. The number of living donors—a critical solution to the growing crisis—has remained stagnant over 20 years, in part because Medicare has not been leveraged to expand living kidney donation. According to a recent independent analysis using Congressional Budget Office scoring methodology and detailed in KTC’s whitepaper, each kidney transplant saves Medicare an estimated $800,000 over 10 years. Doubling the number of living donor transplants from just over 6,000 annually to 12,000 could reduce Medicare expenditures by $6.6 billion, an enormous savings.

“Living kidney donation is a proven pathway for addressing the growing kidney transplant waitlist,” said Dr. Louis H. Diamond, MBChB, FCP (SA), FACP, FHIMSS, Chairman Emeritus of the Kidney Transplant Collaborative. “KTC remains committed to advocating for policies that remove barriers and support donors and recipients throughout the transplant process.”

“Dialysis is incredibly taxing on patients and families from a physical, emotional, and financial standpoint,” said Dr. Stephen Pastan, Associate Professor of Medicine, Emory University School of Medicine and Medical Director Kidney & Pancreas Transplant Program Emory Transplant Center. “A transplant means freedom, longevity, and lower costs. By investing in living kidney donation, we’re giving patients the opportunity for a far better future.”

To read the whitepaper and learn more, please click here.

About the Kidney Transplant Collaborative

The Kidney Transplant Collaborative (KTC) is a 501(c)(4) nonprofit organization dedicated to increasing kidney transplants and eliminating 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.