For many individuals with chronic kidney failure, transplantation is the preferred course of treatment.  It often provides a better quality of life and increased opportunity to participate in the workforce than kidney dialysis.  Policymakers must do everything possible to expand organ donation and protect the viability of the donated organ, and the kidney community works with Congress in this regard.

Medication compliance is one of the most important ways to help insure the long term functioning of a transplanted kidney. To this end, the National Kidney Foundation and multiple other patient and professional transplant organizations are collaborating to enact legislation (S. 323, H.R. 1428) to provide lifetime Medicare coverage of immunosuppressive drugs. Most Americans with chronic kidney failure qualify for Medicare regardless of age and have lifetime Medicare coverage as a dialysis patient; however, if they receive a transplant their Medicare eligibility ends 36 months later unless they are Medicare-aged or Medicare-disabled.  Making this particularly hard to fathom for patients, families, donors and transplant professionals is Medicare expenditures for a transplant recipient are about one-fourth what they are for a dialysis patient.

The Medicare immunosuppressive drug benefit was limited initially to 12 months, later extended to 36 months, and in 2000 was made permanent for aged and disabled kidney recipients.  NKF is committed to obtaining lifetime Medicare immunosuppressive coverage for ESRD beneficiaries through S. 323 and H.R. 1428 for individuals who do not have other insurance coverage for these medications. The legislation would extend Medicare beyond the three-year limit for immunosuppressive drug coverage only.  We will continue to work closely with our congressional supporters and with other members of the transplant community to realize this mutual goal.

Assisting living kidney donors

Kidney paired donation involves two or more individuals who donate their kidneys to two or more recipients.  These have become increasingly common and it is not unusual to hear of a kidney chain that involves 30 or more donors and recipients.  This was made possible by the enactment of the “Charlie W. Norwood Living Organ Donation Act” (Public Law 110-144).  By clarifying that kidney paired donations do not violate the National Organ Transplant Act (NOTA) prohibition against “valuable consideration,” would-be donors who are not medically compatible with their intended recipients are able to donate to another kidney patient while their intended recipient receives a kidney from a different donor.

Living donors should not have to bear a financial burden if they want to help a family member of friend in need.  To address this concern, Congress established a federal grant program under the Organ Donation and Recovery Improvement Act of 2004 (P.L.108-216) to make it easier for individuals of limited financial means to donate. The program helps offset verifiable non-reimbursable expenses related to donation, such as travel and subsistence expenses. The National Living Donor Assistance Center is administered by the American Society of Transplant Surgeons under a contract agreement through the Health Resources and Services Administration of the U.S. Department of Health and Human Services.  More than 3,400 individuals have benefited from the program since its inception.