Abstract: FR-PO1004
Anticipating the Future of Living-Donor Kidney Transplantation Rates in the United States
Session Information
- Transplantation: Clinical - Pretransplantation, Living Donation, and Policies
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Jain, Parshav, Birla Institute of Technology & Science Pilani - K K Birla Goa Campus, Zuarinagar, GA, India
- Pandey, Abhishek, Yale School of Public Health, New Haven, Connecticut, United States
- Kumar, Abhishek, Yale School of Medicine, New Haven, Connecticut, United States
Background
Living donor kidney transplantation is the preferred treatment for end stage kidney disease. The incidence of ESKD has increased by 31% in the last two decades. Increase in living donation can address organ shortage, however population health trends show nuanced changes, and we aim to evaluate how evolving U.S. demographics may influence living donation eligibility.
Methods
We used National Health Interview Survey data (2019–2024) to estimate the proportion of U.S. adults eligible for living kidney donation, accounting for diabetes, pre-diabetes, hypertension, and obesity. Eligibility was defined as having none of these conditions, with comorbidities considered. We also explored a relaxed obesity criterion (BMI <35 vs. <30) to assess its impact. Estimates were weighted nationally, stratified by region, and projected through 2029.
Results
We found that the percentage of the U.S. population eligible for living kidney donation has declined steadily, from 51.2% in 2019 to 48.6% in 2025. If current trends continue, eligibility is projected to fall further to approximately 46.3% by 2029 (figure). Relaxing the BMI criterion from <30 to <35 would increase the eligible population by 10.9 percentage points in 2025, adding approximately 28.4 million additional individuals who could qualify as living kidney donors.
Conclusion
Our study shows a declining trend in the percentage of the U.S. population considered healthy enough to serve as living kidney donors. While relaxing BMI eligibility criteria could expand the donor pool, sustained population-level interventions and public policy efforts aimed at achieving financial neutrality and strengthening donor protections are essential to increase living donation rates.