Kidney donations decline ‘for all the wrong reasons,’ report finds

For the first time in the 21st century, the U.S. recorded an isolated decrease in deceased kidney donations, according to a Jan. 14 report from the Kidney Transplant Collaborative. 

The report, “Losing Transplants for All the Wrong Reasons: A Statistical Analysis of the Reduction in Kidney Transplants in Response to Reports of OPO [Organ Procurement Organization] Failures,” details a decline in overall kidney transplants from 2024 to 2025. 

Although living donor kidney transplants increased and the kidney discard rate declined in 2025, the decline in deceased kidney transplants and donations led to an overall decline in transplants. 

The Kidney Transplant Collaborative, a nonprofit organization focused on increasing the number of living donor transplants in the U.S., said recent industry oversight and negative media reports have rattled the landscape. 

“While policymakers have been appropriately focused on maintaining the integrity of the  deceased donor process, an unanticipated effect of recent oversight efforts of the kidney  transplant system and accompanying negative media reports has shaken the deceased donor  landscape and may have possibly caused the reduction in deceased donor rates,” the report said. 

In mid-2025, HHS said it found patient safety concerns in a probe of a Kentucky organ procurement organization. The investigation focused on donation after circulatory death, which involves patients with some brain function who are on life support and are not expected to recover. The Kentucky organization denied the investigation’s findings. 

More recently, CMS rolled out national reforms to the organ transplant system; decertified the Life Alliance Organ Recovery Agency, previously a division of the University of Miami Health System in Florida; and selected a Nevada agency to manage organ procurement services in Southern Florida. 

Organ procurement organizations “may be operating more cautiously in response to investigations, legal exposure and public scrutiny, particularly in Donation After Circulatory Death cases that historically supported transplant growth,” the Kidney Transplant Collaborative said in a Jan. 14 news release. 

From 2024 to 2025, the Kidney Transplant Collaborative recorded 116 fewer kidney transplants. Nearly 100,000 Americans are waiting to receive a kidney transplant. 

“Without immediate action, more patients will be pushed onto long-term dialysis and a system already stretched thin will face mounting pressure both financially and logistically,” the release said. “Policymakers, hospitals and transplant leaders should not sit on the sidelines thinking this crisis will solve itself.”

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