7,237
Living donors in 2025, a 3% increase over the prior year
Living Donor Program
One living donor.
One life transformed.
In 2025, over 7,200 people became living organ donors in the United States. Living donor transplants last longer and have better outcomes, but the decision should always be informed, voluntary, and pressure-free.
97%+
One-year graft survival rate for living donor kidney transplants
13.9 yr
Median graft half-life for living donor kidneys vs 9.7 years from deceased donors
0.02%
Perioperative mortality risk for kidney donation (2.2 per 10,000 donors)
What You Can Donate
Living donors can give more than you think.
While kidney donation is by far the most common, several organs and tissues can be donated by living individuals.
Most Common
Kidney
One kidney is removed and transplanted. The remaining kidney enlarges and compensates, performing about 80% of the work two kidneys normally do. Over 90% of living donor transplants are kidneys.
Growing
Liver Segment
A portion of the liver is removed and transplanted. The donor's liver regenerates to 80–90% of its original size within three months. In 2025, 709 living liver transplants were performed, a record.
Rare / Emerging
Other Organs
Lung lobes, pancreas segments, intestine segments, and even uterus transplants are possible from living donors, though these procedures are uncommon and performed at specialized centers.
The Process
Five steps from interest to donation.
The full evaluation typically takes several months. Starting the process does not obligate you to donate. You can stop at any time.
1
Contact a Center
Self-refer by calling any transplant center directly. No physician referral is needed. An initial screening covers blood type and basic medical history.
2
Medical Evaluation
Comprehensive testing: blood panels, CT/MRI imaging, cardiac evaluation, 24-hour urine collection, infectious disease screening, and cancer screenings.
3
Psychosocial Review
A licensed mental health professional assesses your decision-making capacity, motivation, and support systems. An Independent Living Donor Advocate (ILDA) protects your rights throughout.
4
Committee Approval
The transplant team reviews all results and determines candidacy. If approved, you have full control over timing. If not, the team explains why.
5
Surgery & Recovery
Kidney donation is typically laparoscopic (2–4 hours, 1–3 day stay). Liver donation is open surgery (4–8 hours, 5–7 day stay). Most donors return to work in 4–8 weeks.
Types of Living Donation
Multiple pathways to give the gift of life.
Most Common
Directed Donation
You donate to a specific person, like a family member, spouse, friend, coworker, or someone you've connected with. One in four living donors is not biologically related to their recipient.
Altruistic
Non-Directed Donation
You donate without knowing the recipient. The match is arranged based on medical compatibility. Non-directed donors often initiate kidney chains that save multiple lives.
Chain Reaction
Paired Exchange
If you're incompatible with your intended recipient, paired exchange programs match you with another pair. One altruistic donor can trigger a chain that saves many lives through coordinated swaps.
Eligibility
Who can be a living donor?
Requirements vary by transplant center, but these are the general guidelines used across the United States.
General Requirements
- At least 18 years old (some centers require 21+)
- In good overall physical and mental health
- BMI generally under 35 (30–35 may require weight loss first)
- Able to provide informed, voluntary consent
- Free from coercion or financial inducement
- No upper age limit, and donors in their 70s have donated successfully
Conditions That Typically Disqualify
- Uncontrolled high blood pressure
- Diabetes (type 1 or type 2)
- Active or recently treated cancer
- HIV, hepatitis B, or hepatitis C
- Significant heart or lung disease
- History of blood clots or bleeding disorders
- Active substance abuse
Surgery & Recovery
What to expect before, during, and after.
Kidney Donation
- Surgery: Laparoscopic (standard of care), 2–4 hours, 3–5 small incisions
- Hospital stay: 1–3 days (average 2 days)
- Return to desk work: ~4 weeks
- Return to physical labor: ~6 weeks
- Full activity: 4–6 weeks, athletics 6–12 months
- Mortality risk: 0.02% (2.2 per 10,000)
- Complication rate: 95–96% of donors have no complications
Liver Donation
- Surgery: Open abdominal surgery, 4–8 hours
- Hospital stay: 5–7 days (including overnight in ICU)
- Liver function recovery: 2–4 weeks
- Return to work: 6–8 weeks
- Liver regeneration: 80–90% in ~3 months, full in ~1 year
- Mortality risk: ~0.2% (1 in 500)
- Complication rate: 15–25% (higher than kidney)
Understanding the Risks
Honest information helps you decide with confidence.
All surgery carries risk. ODAP believes you deserve complete, transparent information. We believe you deserve the full picture, not just the positive outcomes.
Surgical Risks
Short-Term
Pain at the incision site, infection, blood loss, blood clots, allergic reaction to anesthesia, pneumonia, or injury to surrounding tissue. Minor complications occur in 10–20% of kidney donations; major complications in fewer than 3%.
Long-Term Health
Kidney Donors
Expect a 20–30% decrease in kidney function (manageable with one kidney). Estimated lifetime risk of kidney failure: 0.9% (90 per 10,000). Slightly elevated risk of high blood pressure over time. Studies show donors live as long as or longer than the general population.
Emotional Impact
Psychological
97% of donors report being almost or fully recovered. However, up to 25% judge their health as worse afterward, and 31–44% worry about future health. Depression prevalence in liver donors is ~6%, anxiety ~10%. Relationship dynamics with the recipient may change.
Money & Legal Protections
What donation costs, and how you're protected.
Financial Considerations
- Covered by recipient's insurance: Donor evaluation, surgery, and limited post-op follow-up
- Not typically covered: Transportation, lodging, lost wages, childcare, long-distance travel
- NLDAC assistance: Up to $6,000 reimbursement for travel, lodging, lost wages (up to 6 weeks), and childcare. 80% of assisted donors say they could not have donated without it
- State tax benefits: Several states offer deductions up to $10,000 for donation-related expenses
- Proposed federal credit: The Living Organ Donor Tax Credit Act would provide a $5,000 refundable tax credit
Legal Protections
- FMLA: Organ donation qualifies as a “serious health condition,” with up to 12 weeks of unpaid, job-protected leave
- Living Donor Protection Act: Would prohibit insurance discrimination against living donors for life, disability, and long-term care insurance
- Your right to stop: You can withdraw at any time. Your decision will be kept confidential and not disclosed to the recipient
- Independent Donor Advocate: Required by OPTN policy. An independent advocate protects your rights and interests throughout the entire process
After Donation
Your health matters for the long term.
Required Follow-Up
OPTN policy mandates that transplant programs track your health at discharge, 6 months, 1 year, and 2 years post-donation. Programs that fail to meet reporting thresholds face review.
- Serum creatinine and urine protein labs
- Blood pressure monitoring
- Complication and adverse event tracking
- General health status assessment
Lifelong Recommendations
The 2-year requirement is a minimum. Advocacy groups and researchers call for extended follow-up. ODAP recommends:
- Maintain a primary care physician relationship
- Annual checkups including kidney function tests (eGFR) and urine protein
- Monitor blood pressure regularly
- Maintain a healthy weight, exercise, avoid smoking
- Stay hydrated and moderate alcohol consumption
Frequently Asked Questions
Can I be forced to continue the donation process?
No. Living donation is entirely voluntary. You may stop the process at any stage without explanation. Your decision to withdraw is kept confidential. The transplant team will provide a medically acceptable reason to the recipient without revealing your decision.
Do I need a doctor's referral to start?
No. You can self-refer by contacting any OPTN-approved transplant center directly. If donating to a specific person, contact the center where the recipient is listed. If donating altruistically, contact any center.
How long does the entire evaluation take?
The median duration from start of evaluation to donation is approximately 10 months. Some centers offer accelerated evaluation programs. The timeline depends on test scheduling, results, and your availability.
Will my remaining kidney be enough?
Yes. The remaining kidney enlarges and compensates, performing about 80% of the work that two kidneys normally do. Studies show living kidney donors live as long as or longer than the general population. The estimated lifetime risk of kidney failure for donors is less than 1%.
What if I'm not compatible with my intended recipient?
Paired kidney exchange programs can help. You donate to a compatible recipient from another pair, and your intended recipient receives a kidney from that pair's donor. Programs like the National Kidney Registry and UNOS Kidney Paired Donation coordinate these swaps nationwide.
Who pays for the surgery?
The recipient's insurance covers donor evaluation, surgery, and limited follow-up. Out-of-pocket costs like travel, lodging, and lost wages may be reimbursed through the NLDAC (up to $6,000). Several states also offer tax deductions for donation-related expenses.
Will donating affect my insurance?
Currently, protections vary by state. The Living Donor Protection Act (introduced in Congress) would prohibit insurance companies from denying or varying terms of life, disability, or long-term care insurance based solely on living donor status. Check your state's specific protections.
What is an Independent Living Donor Advocate?
Required by OPTN policy, the ILDA is someone independent of the recipient's care team who advocates for your rights and best interests. They ensure your decision is voluntary, help you understand the process, and are available throughout your entire evaluation and consent process.
Does ODAP replace medical guidance from transplant teams?
No. ODAP provides educational support to help you prepare for informed discussions with qualified clinicians. Always consult your transplant team and personal physician for medical advice specific to your situation.
Take the Next Step
Ready to learn more or get started?
Whether you register as a posthumous donor or explore living donation, every action makes a difference.
Sources & Further Reading
All information on this page is drawn from authoritative medical and government sources. ODAP does not provide medical advice.