Exclusive: Kidney donations dip amid transplant scrutiny
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The number of available donor kidneys from people who just died declined for the first time in more than a decade last year, according to a new analysis of national data by the Kidney Transplant Collaborative.
Why it matters: The drop comes after thousands of people have removed themselves from U.S. organ donor registries amid renewed scrutiny of the transplant system, including reports over the summer that organs were being removed while donors still showed signs of life.
- Kidneys are the most-needed organs in the U.S. Some 94,000 people in the country are waiting for a kidney transplant at any time.
What they're saying: "This reversal will cost lives, as fewer donated organs mean fewer lifesaving transplants for Americans who urgently need them," the Association of Organ Procurement Organizations told Axios. The group didn't take part in the analysis.
State of play: The number of deceased kidney donors dipped from 15,937 in 2024 to 15,274 last year, driving a slight decrease in year-over-year kidney transplants.
- Kidney donations among living people rose to 6,521 from 6,419 the year before. Fewer donor kidneys were discarded prior to transplant in 2025, also mitigating the effects of the drop in deceased donors.
Zoom in: The number of kidneys recovered from deceased donors declined starting in June, per KTC's analysis.
- A Senate investigation released that month raised serious patient safety concerns surrounding transplantation, citing examples of inappropriate conduct and conflicts of interest among organ procurement organizations.
- Congress has debated overhauling the organ transplant system for more than five years, and the June report kicked off additional scrutiny. The Trump administration in September decertified a Miami group that distributes donated organs, citing unsafe practices, errors and underperformance.
Flashback: The last time overall kidney transplants declined was in 2020, when living donations fell due to the COVID-19 pandemic.
- Donations from people who just died haven't declined since 2012, when a new allocation system resulted in an increased kidney discard rate, said Andrew Howard, a nephrologist and president of the Kidney Transplant Collaborative.
Zoom out: Congress should continue its oversight of the organ procurement organizations and the broader transplant system, but policymakers also need to be mindful of the consequences, Howard said.
- Federal support to improve the number of living donors could help solve the problem, he said.
- Clinical evidence from Johns Hopkins University and the University of Alabama at Birmingham shows that trained transplant facilitators boost living donations by guiding patients and donors through the process.
- "We know people want to be living donors. They're willing to do it, but we have to find a way to help them, and we feel the federal government needs to take action," Howard told Axios.
