University of Wisconsin–Madison Medical College of Wisconsin

Living Donor Protection Act: A Call to Action

Kurtis J. Swanson, MD

WMJ. 2023;112(1):9.

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Chronic kidney disease and end-stage kidney disease are serious, emerging problems nationally and for our patients here in Wisconsin. In its most recent annual report, the National Kidney Foundation of Wisconsin contextualizes the burden of kidney disease in Wisconsin: 84,000 patients and families live with the diagnosis of chronic kidney disease. Over 6,800 people in Wisconsin are on dialysis. Over 1,300 men and women are waiting for a kidney transplant.1 These numbers have only increased since this report was published in 2019. Yet, there is hope.

Kidney transplantation—particularly living donor kidney transplant—provides the gift of life for Wisconsinites afflicted with kidney disease. According to the Scientific Registry of Transplant Recipients, nearly 120 living donor transplants are performed in adult and pediatric patients in Wisconsin annually.2-3

Prospective living donors face many barriers to providing the gift of life, including financial challenges such as loss of income/employment and difficulties securing life, disability, and long-term care insurance. In a multicenter study performed by the Kidney Donor Outcomes Cohort, Rodrigue et al noted that 92% of donors incurred direct costs (median $433, range $6–$10,240), and more than one third (36%) reported lost wages in the first year after donation (median $2,712, range $546–$19,728).4

In response to these substantial hindrances, policymakers have crafted bipartisan legislation—the Living Donor Protection Act (HR 1255/S 377)—which would serve to protect living donors from wage loss by organizing Family Medical Leave Act protections and preventing insurance denials/conditions. As described in its recent statement, the National Kidney Foundation summarizes how this act will protect living donors and promote live organ donation in three primary ways:5

  1. Prohibit life, disability, and long-term care insurance companies from denying and/or limiting coverage, as well as charging higher premiums for living donors.
  2. Amend the Family and Medical Leave Act of 1993 to specifically identify living organ donation as a serous health condition for private and civil service employees.
  3. Direct the US Department of Health and Human Services to update materials on live organ donation to reflect these new protections and promote living organ donation.

As members of our medical community in Wisconsin, as well as our statewide constituency, we can use our collective voice to advocate for the health and well-being of our living donors and recipients of these gifts. I urge you to reach out to our congressional representatives to make the Living Donor Protection Act a reality.

For more information or if you would like to get involved , visit the American Transplant Foundation Living Donor Laws guide and the Voices for Kidney Health website supported by the National Kidney Foundation.6,7

  1. Annual Report. 2019. National Kidney Foundation of Wisconsin.
  2. Scientific Registry of Transplant Recipients: Kidney Transplant Centers in Wisconsin-Adult. Transplant Centers. Accessed October 11, 2022.
  3. Scientific Registry of Transplant Recipients: Kidney Transplant Centers in Wisconsin-Pediatric. Transplant Centers. Accessed October 11, 2022.
  4. Rodrigue JR, Schold JD, Morrissey P, et al; KDOC Study Group. Direct and indirect costs following living kidney donation: findings from the KDOC study. Am J Transplant. 2016;16(3):869-76. doi:10.1111/ajt.13591.
  5. Congress should act on Living Donor Protection Act during Donate Life Month. April 6, 2022. National Kidney Foundation. Accessed December 6, 2022.
  6. Living Donor Laws: Federal and State by State. American Transplant Foundation. January 2022. Accessed March 9 2023.
  7. Ask Congress to Support and Pass the Living Donor Protection Act. Voices for Kidney Health. National Kidney Foundation. Accessed March 9 2023.

Author Affiliations: Division of Nephrology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (Swanson).
Corresponding Author: Kurtis J. Swanson, MD, Assistant Professor of Medicine, Division of Nephrology, University of Wisconsin School of Medicine and Public Health, 1685 Highland Ave, Madison, WI 53705, phone 608.262.5869; email; ORCID ID 0000-0001-5952-9054
Funding/Support: None declared.
Financial Disclosures: None declared.
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