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You're past curiosity. Now you need honest numbers.

Money, risk, time off work, and whether you would even qualify — with sources, and with the uncomfortable parts said plainly.

The facts people actually weigh

Every figure here is sourced and dated, and none of it is dressed up. The risks are real and worth reading exactly as written.

$0
the donor pays for surgery and testing
The recipient's insurance or Medicare covers the donor's evaluation, the operation, the hospital stay, and donation-related follow-up. The donor does not get a medical bill. What is not covered is the real burden — lost wages, travel, and childcare.
National Kidney Foundation, reviewed 2026
See who pays for what
$6,000
available toward lost wages, travel and childcare
The National Living Donor Assistance Center reimburses up to $6,000 per donor. NLDAC is changing its rules so that who qualifies depends on the donor's own income, not the recipient's, and your transplant center can tell you which rules are in use now. Costs only count once you are approved, so it helps to start the process early.
NLDAC, re-verified September 26, 2026
See who pays for what
30.8 per 10,000
donors develop kidney failure within 15 years
Against 3.9 per 10,000 among matched non-donors in equally good health. Donating raises the risk, and that is worth saying plainly. The absolute difference is about a quarter of one percentage point over fifteen years — more than 99.5% of donors do not develop kidney failure in that window.
JAMA — Muzaale et al., 2014, 96,217 donors, matched healthy cohort
See the risk, dot by dot
24%
of living kidney donors had a BMI over 30
Most people rule themselves out before anyone else does. The median donor is a woman in her forties, and donors over 55 are a growing share. Getting screened is free, private, and commits you to nothing.
OPTN/SRTR Annual Data Report, 2024 data, published 2026

Kidney failure within 15 years, out of every 10,000 people

Donors

30.8 in 10,000

Similar healthy people who did not donate

3.9 in 10,000

Each dot is one person.Donating raises the risk of kidney failure. Even so, in both groups the great majority did not develop it in that time.The risk is not the same for everyone: in this study it was higher for Black donors than for white donors. The transplant team will talk through yours.Estimated risk over 15 years, for donors compared with matched healthy people who did not donate. Source: JAMA — Muzaale et al., 2014, 96,217 donors, matched healthy cohort.

Money, and whether your job is safe

The two questions people actually stall on. Both have concrete answers, and both are better than most people assume — but the answer about your job depends heavily on your state, so look yours up.

What would it actually cost you?

  • The recipient's insurance or Medicare

    You pay $0 for testing and surgery.

    • Evaluation
    • Surgery
    • Hospital stay
    • Donation-related follow-up

  • The National Living Donor Assistance Center (NLDAC), if you qualify

    Up to $6,000 toward travel, lodging, lost wages and dependent care. NLDAC is changing its rules so that who qualifies depends on your own income, not the recipient's, and your transplant center can tell you which rules are in use now. Costs count only from the day you are approved.

    • Travel
    • Lodging
    • Lost wages
    • Dependent care

  • Your state's laws

    Protections for your job, and for life and disability insurance, differ a lot from state to state. Check yours below

    • Job-protected leave
    • Paid leave
    • Tax credits
    • Life and disability insurance protections
The recipient's insurance covers the medical costs of donating. What it leaves are time, travel and work, and there is some help for those too.Sources: National Kidney Foundation; NLDAC, re-verified September 26, 2026; American Kidney Fund, Living Donor Protection Report Card.
Want a rough number for your situation?

Most donors are back to normal activity in about four to six weeks.

$
$

Evaluation usually means several trips, not one.

$

Could be reimbursed, if you qualify

$4,600

of about $4,600 in lost pay, travel and care.

Apply early: costs only count from your approval date. Your center’s donor advocate helps with the paperwork.

An estimate, not a quote. My Kidney Story can’t approve anything. NLDAC, re-verified September 26, 2026.

Your state: job protections and nearby centers

How safe your job and insurance would be depends on where you live. Pick your state to see its protections and the transplant centers there.

Federal family leave can already cover donation. A law written for living donors has not passed yet.

The Department of Labor's position, set out in a formal opinion letter, is that donation surgery and the recovery after it count as a serious health condition under the Family and Medical Leave Act whenever they involve an overnight hospital stay, as donation surgery commonly does. So if you are eligible under that Act, you can take leave to donate and recover, come back to the same or an equivalent job, and keep your group health cover while you are away. The leave itself is unpaid, though paid leave your employer offers can run alongside it. Eligibility depends on the size of your employer and your workplace, and on how long and how many hours you have worked there — the Department of Labor's fact sheet sets out the exact tests, and your employer's HR team can confirm them for you.

The Living Donor Protection Act would write that leave protection into the law itself, and would stop life, disability and long-term care insurers from refusing cover or charging more because you donated. It has not passed. The Senate version has cleared its committee and is awaiting a floor vote; the House version has not moved since it was introduced. Paid leave, and protection for anyone the family-leave law does not reach, depends on what your state has done.

U.S. Department of Labor, opinion letter FMLA2018-2-A; U.S. Department of Labor, FMLA eligibility fact sheet; Congress.gov, S. 1552 / H.R. 4583, checked 24 September 2026.

One correction worth making, because people conflate the two: the Affordable Care Act already prohibits health insurers from denying you cover or charging you more for having donated. The state laws above are about life, disability and long-term care insurance, which is a different and genuinely unprotected thing in much of the country.

Ask someone who has sat with this decision

Mentors can tell you what it cost them, how the recovery went, and how they are years later. They will not tell you what to do — nobody here will.

What it cost meThe surgery and recoveryTime off workHow I am years laterTelling my familyPaired exchangeHow I asked peopleBeing on the list
Talk to someone who has done this

You decide, repeatedly — and you can always stop

Nothing about looking into this commits you. People step back at every stage, for every kind of reason, and the process is designed so that stopping is easy, private, and never held against you. The transplant center gives every candidate an independent advocate whose whole job is your interests, not the recipient's. If you get a no from the medical team, or you say no yourself, nobody is told the details unless you choose to share them.

Still wondering about something?

Ask in your own words. The assistant only draws on the sourced material this guide is built from — and for lived experience, the mentors are real people.

Ask the guide anything

This assistant shares general information about living donation — it is not medical advice, it cannot tell you whether you could donate (only a transplant team can), and this conversation is not saved.

When you are ready to find out whether you could actually donate, the last page shows you exactly what that first step looks like.

3. I want to find out if I could donate

My Kidney Story does not collect, store, or evaluate medical information, and nothing on this page is medical advice. Donor eligibility is determined solely by a transplant center after its own independent evaluation.