The best & most economical treatment for kidney failure is a living kidney donor transplant.

Vision for dialysis and transplant

The best treatment for kidney failure is a living kidney donor transplant.

There is a culture of silence around the best treatment.

The best treatment is the least discussed.

And too many people are dying.

Most people believe getting a deceased donor kidney transplant is the same as getting a living donor kidney transplant. That is not true. 

A deceased donor kidney transplant:

  • Takes on average 5 years to get a kidney
  • Lasts about 10 years

A living donor kidney transplant:

  • Has less waiting time (around a year or less; the time it takes for a living donor workup)
  • Lasts about 20 years

High Cost of Dialysis and Deceased Donors

Besides living longer, people with a kidney transplant cost taxpayers and the government less money. Hemodialysis care costs the Medicare system an average of $121,000 per patient-year. The cost of a kidney transplant is about $145,000. Then the medical costs are about $32,000 each year after.

Hemodialysis also creates a huge environmental burden. With over 100,000 people on in-center dialysis, each year just one person on hemodialysis uses over 5,000 gallons of quality water. The electricity used for one treatment is about the same as for an average household for one day. Each dialysis treatment creates up to 18 pounds of plastic and cardboard waste. Dialysis also contributes to massive carbon dioxide emissions through water, energy, consumables usage, and transportation for staff and patients. The United Kingdom estimated hemodialysis patients have a more than 7-fold patient carbon footprint. Much of this waste is eliminated with a kidney transplant.

Deceased donor transplant costs are rising and living donor transplant cost is lower. It takes more money to keep people on the transplant list over the years and many tests will need to be repeated annually. The Organ Procurement Organizations cost money to maintain buildings, staff, computer systems, and the day-to-day business related to the deceased donation process and maintaining the waiting list.  There are fewer resources required for a living kidney transplant.

A living donor transplant is the most economical.

Not everyone will be healthy enough to get a kidney transplant. But there are many people on dialysis that have never been offered guidance or given the option of a kidney transplant. Health declines as the number of years on dialysis increases. If dialysis is necessary, discussions of kidney transplants should take place as early as possible after starting dialysis. Race disparities are a huge problem for those with kidney disease and those on the transplant waiting list. This problem has not changed over the years. Everyone should be offered the best treatment as early as possible.

This image represents the current state of chronic kidney disease with 71% of people on dialysis and 29% having a kidney transplant.


Reality of dialysis and transplant triangle


It’s time to break the silence and provide everyone with chronic kidney disease the information needed to explore the best treatment option: a living kidney transplant. The earlier in the process of kidney decline that living donation is discussed, the better. Planning ahead in Kidney Disease Stage 4 or before will provide more time to find a living donor before going on dialysis. And, we need more living kidney donors to provide healthy kidneys to people before they die.

This image is the vision we see for the future.


Vision for dialysis and transplant

Consider This!

The best and most economical treatment for kidney failure is a living kidney transplant. Share our vision of a world where everyone has one healthy kidney and no one is left behind on a waiting list.


Maybe you would like to know if you are healthy enough to be a living kidney donor.

For help, go to Kidney Donor Conversations at


Annual Data Report | USRDS. (n.d.). Retrieved August 23, 2022, from
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Held, P. J., McCormick, F., Ojo, A., & Roberts, J. P. (2016). A Cost-Benefit Analysis of Government Compensation of Kidney Donors. American Journal of Transplantation, 16(3), 877–885.
Kidney Disease Statistics for the United States. NIDDK. (n.d.). Retrieved July 27, 2022, from
Wang, J. H., & Hart, A. (2021). Global Perspective on Kidney Transplantation: United States. Kidney360, 2(11), 1836–1839.
Wesselman, H., Ford, C. G., Leyva, Y., Li, X., Chang, C. C. H., Dew, M. A., Kendall, K., Croswell, E., Pleis, J. R., Ng, Y. H., Unruh, M. L., Shapiro, R., & Myaskovsky, L. (2021). Social
Determinants of Health and Race Disparities in Kidney Transplant. Clinical Journal of the American Society of Nephrology : CJASN, 16(2), 262–274.
Yeo, S. C., Ooi, Y., Suet, T., & Tan, M. (2022). Sustainable kidney care delivery and climate change – a call to action. Globalization and Health 2022 18:1, 18(1), 1–4.


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Glenna Frey, APRN-CNS, is a nephrology nurse who donated her kidney in April 2017 to a stranger.
Amanda Frey, M.A., LMFT, LPC, is a Marriage & Family Therapist living with kidney disease.
Together, they co-founded Kidney Donor Conversations in 2018 to provide education about Living Kidney Donation.


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