#United States #New York #kidney transplant #organ donation #KTC

Decline in Kidney Transplants: A Growing Crisis

In a recent alarming report released by the Kidney Transplant Collaborative (KTC), a significant and unprecedented decline in kidney transplants was documented for the year 2025. Titled Losing Transplants for All the Wrong Reasons, the report highlights various concerning trends in organ donations, particularly focusing on the decrease in deceased kidney donations. This decline poses a serious threat to patients who are already facing lengthy wait times for transplants.

Key Findings

The report reveals that, for the first time this century, the number of deceased donations has declined while simultaneously, the number of living donor kidney transplants has increased. Despite this rise in living donations, the overall total of kidney transplants dropped in 2025, with 116 fewer procedures taking place across the United States compared to the previous year. This particular year marked a critical inflection point, highlighting systemic issues within the organ donation landscape.

Factors Behind the Decline

According to the KTC report, three primary factors have contributed to this alarming decline:
1. Public Confidence Erosion: High-profile incidents involving failed organ recoveries have significantly shaken public trust. When potential donors witness attempts to recover organs from individuals who later show signs of life, it leads to hesitancy regarding organ donation.
2. Increased Donor Withdrawals: There has been a notable uptick in the number of individuals who choose to withdraw from donor registries, further limiting the pool of available organs for transplantation.
3. Caution Among Organ Procurement Organizations (OPOs): Investigations and legal challenges have led OPOs to operate more cautiously, especially concerning Donation After Circulatory Death cases—a method historically crucial in supporting transplant growth.

These factors collectively indicate a troubling shift in how the public and medical community interact with the kidney transplant system, which could have dire consequences for patients awaiting transplants.

Patient Impact

With over 94,000 individuals currently on the kidney transplant waiting list, a decrease in donations exacerbates an already critical situation. Patients typically face wait times of three to five years, with 12 to 17 people dying each day while waiting for a suitable donor. The decrease in deceased donations could lead to an unavoidable crisis if immediate interventions are not implemented.

Call for Urgent Action

Dr. Andy Howard, Chair of the KTC, expressed that the transplant community must urgently address these developments to safeguard patient lives. He emphasized that while living donations are rising, they alone cannot fill the gap created by the reduction in deceased donations. The KTC is advocating for the expansion of access to living kidney donors and better support systems to boost donor registration and retention.

Dr. Howard asserts, “The evidence consistently shows that living kidney donations can increase transplant rates when patients and donors receive real support and navigation.” The report outlines strategies for bolstering living donation initiatives, urging policymakers and healthcare leaders to take immediate action.

Solutions on the Horizon

To mitigate the decline in kidney transplants, the KTC proposes a national living donor support initiative that would draw on successful models from leading transplant centers, such as Johns Hopkins and the University of Alabama at Birmingham. These programs show promise in significantly increasing donor rates through dedicated support and facilitation of potential living donors.

In conclusion, the findings presented by the KTC are a wake-up call for healthcare professionals, policymakers, and the general public. Without rapid and coordinated efforts to rebuild trust and enhance support for living kidney donation, more patients may face the daunting transition to long-term dialysis, further straining an already beleaguered healthcare system. The path forward is clear: immediate action is necessary to protect lives and preserve the integrity of kidney transplant networks across the nation.