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While awaiting passage of a federal Living Donor Protection Act (LDPA), more than half of states now have their own version (28 at last count). In fact, like North Carolina, some actually are more generous than the federal version (by including paid leave for state employees who donate).

But the LDPA is just one way that states can encourage living donation. Financial supports and job protections are other critical ones. Are you considering being a living donor, or have you donated recently? Do you know what the relevant tax provisions and protections are in your state–or in a state you may be looking at? It’s worth doing your homework.

The National Kidney Foundation has a terrific resource in a map you can click on to find out what donation-related laws and protections a particular state offers. Does it have a Living Donor Protection Act, or similar insurance-discrimination protections? Does it also have job-protected living donor leave for private employees? How about for state employees? What about paid leave? What about tax deductions? Even better, what about tax credits?

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National Kidney Foundation
Living Organ Donors Need Your Voice | Living Donor Protection Act

The American Kidney Fund website also features an invaluable resource: a state report card. It rates each state based on important donation-related measures and provides an overall rating on how well that state encourages living donation and removes barriers. Not surprisingly, only a few states merit an A: Arkansas, Connecticut, and Louisiana. Glad to see that more than a dozen at least get Bs, but nearly as many have Cs, a few get Ds (including, alas, North Carolina).

With 106,000 people in this country on the national transplant waiting list (most of them needing a kidney), it seems that the very least we can do is remove the barriers to living donation.

Unfortunately, nine states rate an F–that is, these states failed miserably because they have no donation-related measures in place: Alabama, Michigan, Montana, Nevada, New Hampshire, South Dakota, Tennessee, Vermont, and Wyoming.

The tragedy is that none of these donation measures is really controversial–they shouldn’t be so damn hard to pull off. They are simple, reasonable, common sense ways that a state can demonstrate its support for people who help save a life in this way. In fact, not only does encouraging living donation save lives, for kidney patients it reduces costs by reducing the number of people on dialysis (Medicare pays about $90,000 a year per dialysis patient).

With 106,000 people in this country on the national transplant waiting list (most of them needing a kidney), it seems that the very least we can do is remove the barriers to living donation.

   Photo by Neil Offen

Carol Offen, Contributor

Carol Offen, co-author of The Insider’s Guide to Living Kidney Donation, is a writer, editor, and donation advocate. Her varied career has included turns as a freelance writer for major publications, including Vogue, Esquire, and Family Circle; an author; a book editor; and an editor of health-related materials for a nonprofit research institute.

In 2006 she donated her kidney to her adult son and has been passionate about encouraging living donation ever since.  She has written numerous articles and blog posts including for her blog, Could You Be a Kidney Donor? What to Expect If You Give the Greatest Gift. Offen was the lead author of a “Patients’ Foreword” for a major 2021 textbook for transplant professionals, Living Kidney Donation.  As a National Kidney Foundation advocate and UNOS Ambassador, she’s lobbied members of Congress and state legislators to advance support and protections for living donors and kidney patients. Born and raised in New York City, since 1985 she has lived in Carrboro, North Carolina, with her husband.  Read her full bio.

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