- The Trump administration is proposing major changes to the kidney transplant system.
- The changes would affect kidney donation involving both living and deceased donors.
- Additionally, there would be a push to allow more people to get dialysis at home.
The Trump administration announced its plans on Wednesday to reduce end stage kidney disease by about 25 percent by 2030, proposing a series of changes that would transform the kidney transplant system.
Currently, it’s estimated that 43,000 people who need a kidney transplant die each year due to a shortage of kidneys. Most people with kidney disease currently survive from dialysis, an expensive and complicated procedure that involves being connected to a blood-cleaning machine at a hospital for hours on end.
The president signed an executive order on Wednesday that focuses on transforming the kidney transplant system.
The new proposal has three parts that could help patients with finances, access to organs for donation, and assistance with at-home dialysis:
First, it would provide federal funding to make it financially easier for living donors to donate — by covering travel costs, lost wages, and child care expenses during surgery and recovery — thus increasing living donations.
By lessening the financial burden through federal funding for living donors, officials hope more people will donate and help decrease the transplant waiting list.
Second, it would improve processes with organ procurement organizations (OPOs) so that thousands of organs — including kidneys, intestines, and livers — don’t go to waste each year.
Lastly, it would help patients receive dialysis at home rather than in the large medical centers they must go to today.
The order is one of the biggest initiatives focused on kidney health in decades.
“Kidney failure threatens the life and health of hundreds of thousands of Americans, and many more loved ones and medical professionals devote much of their lives to caring for them,” the United Network for Organ Sharing (UNOS) said in a statement sent to Healthline.
“This visibility and attention highlights the importance of organ donation and the transplant system and we look forward to continuing our work with HHS [U.S. Department of Health and Human Services] and the kidney community to increase the number of transplants.”
End stage kidney disease is on the rise in America in part due to an
The current organ transplant wait lists are astronomical in size, with more than 94,000 of the 113,000 people on the U.S. national organ waiting list in need of a kidney.
This list has been growing swiftly too. Each year, the number of people on it continues to be significantly larger than the number of donors and transplants.
“Kidney disease has become much more prevalent in the U.S. population,” UNOS stated. “Greater attention to the existing need, and substantive efforts to promote organ donation, can help save and enhance many more lives.”
Even with the new initiative, only a fraction of those who need an organ transplant would get one.
The new initiative could potentially help nearly 17,000 receive kidneys and another 11,000 receive other organs, such as livers, lungs, or intestines, officials said.
Living donations are generally more successful in people who receive kidney transplants.
“The act of dying does, in fact, compromise or hurt the organ for a little bit for its longevity,” Dr. Lewis Teperman, the director of transplant services with Northwell Health in Manhasset, New York, told Healthline.
Traditionally, while living donors don’t have to pay for the surgery themselves, they do have to cover travel costs, lost wages, child care fees, and so on during surgery and recovery.
By providing federal funding to help cover travel costs, lost wages, and child care expenses during surgery and recovery, officials hope more people will donate and help decrease the transplant waiting list.
According to UNOS, only 6,442 of the 21,167 kidney transplants done last year were from living donors.
Of course, not everyone has a living donor, so it’s crucial to increase deceased donations as well.
The order plans to do this by further supporting the 58 OPOs that collect organs from the deceased.
In the past, they’ve had varying degrees of success, and many viable organs have gone to waste.
“Certain organs are discarded that can be used. There are actually better preservation techniques to use them, but some of the organs are not usable — so I don’t think all of the organs that are discarded are usable,” Teperman said.
According to Teperman, we can do a better job when it comes to using many of these organs — which is what the order plans to address by incentivizing OPOs and improving their processes.
Currently, people with kidney failure have two treatment options: Get a transplant or receive kidney dialysis at a special center or hospital.
Because not everyone can get a new organ due to the severe shortage, nearly 500,000 people in the United States with kidney disease receive kidney dialysis.
Dialysis is expensive. Patients have to pay for each treatment, which they typically need to get three or four times a week.
It’s also time-consuming, with each session taking hours as a machine works to clean their blood.
Looking forward, officials hope to allow for more people to undergo dialysis at home rather than in a medical center. The executive order also pushes for ways to incentivize dialysis centers to allow more patients to have at-home dialysis.
Receiving dialysis at home may be safer, as there’s less chance of getting an infection, according to Teperman.
In addition, it’s much less disruptive to everyday life.
“Potential benefits for patients include: better long-term survival, improved quality of life, a less restrictive diet (compared to conventional hemodialysis), and the need for fewer dialysis-related medications,” Dr. David Klassen, the chief medical officer with UNOS, told Healthline.
Still, there are limitations. Home dialysis requires careful patient selection and training, and may pose safety concerns along with a heightened burden on the patient’s caregivers, Klassen added.
But overall, the initiative seems to be a huge step in the right direction.
“I think the goals are laudable,” Teperman said. “This is a great first step.”
On Wednesday, the Trump administration announced a new initiative that would transform the kidney transplant system and help thousands receive an organ transplant.
The proposal has three parts: Provide federal funding for living donors, allow for more people to receive kidney dialysis at home rather than in a medical center, and reduce the number of viable organs that go to waste each year.
The goal is to lower end stage kidney disease by about 25 percent by 2030.