When you hear the words “kidney transplant,” one of the first questions that comes to mind is simple but vital: where do the kidneys come from?
It’s an important question—and one with a surprisingly complex answer. While the process involves layers of medical, ethical, and logistical coordination, the high points can be summarized in two main donor sources: living donors and deceased donors. A third category—bionic or artificial kidneys—is being actively researched but isn’t yet available outside of trials.
Let’s break down how these sources work and what the numbers show about transplant trends in the U.S.
The Two Primary Sources: Living and Deceased Donors
1. Living Donors
Living kidney donation is one of the most generous acts a person can perform. Humans can live healthily with just one kidney, and that makes it possible for a friend, relative, or even a stranger to donate one of theirs to someone in need.
The benefits of a living donor transplant include:
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Shorter wait times: You don’t need to stay on the deceased donor list.
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Better outcomes: Kidneys from living donors typically last longer and start functioning faster.
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Planned surgery: Both the donor and recipient can prepare in advance for surgery and recovery.
Living donor transplants are arranged through transplant centers that perform extensive medical, psychological, and compatibility evaluations to ensure safety for both donor and recipient.
2. Deceased Donors
The majority of kidney transplants in the U.S. come from deceased donors—people who have chosen to give the gift of life through organ donation after their death. These donors may have registered through the DMV or an organ donation program, or their families may have made that decision at the time of passing.
The process is coordinated through the United Network for Organ Sharing (UNOS) and regional Organ Procurement Organizations (OPOs). Kidneys are matched to recipients based on factors like blood type, tissue compatibility, medical urgency, and time on the waiting list.
While the process is highly regulated and efficient, the need for organs still far exceeds availability. Tens of thousands remain on waiting lists every year.
The Numbers: Five-Year Snapshot of U.S. Kidney Transplants
To put things in perspective, here’s a look at kidney transplants in the United States over the past five years:
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2020: 23,642 total (5,234 from living donors; 18,408 from deceased donors)
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2021: 24,669 total
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2022: 25,498 total
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2023: 28,142 total
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2024: 27,759 total
That’s 129,710 kidney transplants in just five years—an incredible achievement considering the medical complexity and coordination involved.
Roughly 25–30% of those came from living donors, while 70–75% came from deceased donors.
It’s worth noting that 2020 and 2021 fell within the COVID-19 lockdown period, which significantly disrupted hospital operations and transplant procedures. Many experts believe both years would have seen higher numbers under normal circumstances.
The Future: Artificial and Bioengineered Options
While not yet available for patients, research into bionic, mechanical, and bioengineered kidneys is moving forward rapidly. The goal is to create a device or lab-grown organ that could function like a natural kidney—without the need for lifelong anti-rejection medications.
Projects such as the Wearable Artificial Kidney (WAK) and bio-printed organs are still in experimental stages but offer tremendous hope for the future. If successful, they could one day help address the ongoing shortage of donor kidneys and reduce waiting times dramatically.
A Gift Beyond Measure
Whether a kidney comes from a living donor or a deceased one, each transplant represents something profound—a literal gift of life. Behind every number is a story of courage, generosity, and second chances.
If you’ve received a transplant, take a moment to reflect on that legacy. And if you haven’t yet registered as an organ donor, consider doing so. It’s one of the most meaningful ways to ensure that your life can continue to make a difference—even beyond your own.