Better Incentives, More Kidneys, More Lives

The organ procurement system has long been plagued by inefficiencies, with organs frequently lost or damaged in transit. A 2024 Statecraft interview with Jennifer Erickson and Greg Segal highlighted that the OPTN contractor is 15 times more likely to lose or damage an organ in transit than an airline is to damage a suitcase. Furthermore, there is no real-time tracking of organ shipments, which is concerning given the chronic shortage of lifesaving organs.

One particularly alarming statistic is that 17% of kidneys are offered to deceased patients before being transplanted, leading to delays and missed opportunities. However, changes are being implemented to improve the system. In 2019, President Trump issued Executive Order 13879 to enhance OPO performance with better incentives and to allow living donors to recover more of their costs.

While some improvements have been made, such as GPS-tracking of kidney transfers, the estimated growth in transplants attributed to these policies ranges from 1,055 to 2,110 additional transplants annually, potentially generating significant life-years and quality-adjusted life-years. The End Kidney Deaths Act, H.R. 2687, proposes a $50,000 tax credit for qualifying nondirected living kidney donors, garnering bipartisan support.

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