Sending Office: Honorable Matt Cartwright
Sent By:

116th Congress Co-signers: Beutler, Ryan, Cole, Rush, Dingell, Roybal-Allard, Nadler, Clay, Thompson, Lamborn, Clark, Fitzpatrick, Carson, Gianforte, Engel, Visclosky, Posey


Dear Colleague,


We invite you to join us in sending a letter to Alex Azar, Secretary of Health and Human Services, expressing appreciation for the agency’s work to increase living organ donation, as well as support for providing lost wages assistance for living donors,
including expanding the scope of the National Living Donor Assistance Center (NLDAC).


Living donors face many barriers, many of them spend thousands of dollars in lost wage, travel, childcare, and other expenses associated with surgery. The National Living Donor Assistance Center is a program authorized by 42 U.S.C. § 274f-1 and administered
through the Health Resources & Services Administration that currently reimburses travel expenses for certain qualifying organ donors. A recent peer-reviewed study found that for each $1 spent on the program it yielded $28 in Medicare savings in dialysis costs.
Expanding this program through regulation to reimburse all financial expenses of donation would save both dollars and lives while honoring the service living donor provide to the public and their communities.


If you would like to sign on or have any questions, please contact Jeremy Marcus ( in Congressman Cartwright’s office and Anna Breen ( in Congresswoman Herrera Beutler’s office.


Matthew Cartwright                           Jaime Herrera Beutler

Member of Congress                          Member of Congress                  


This letter is supported by:

Waitlist Zero

National Kidney Foundation

American Society of Transplant Surgeons

American Society of Transplantation

American Society of Pediatric Nephrology

American Society of Nephrology.

American Transplant Foundation

Donor to Donor

Kidney Connection

Kidney Donor Conversations

Living Bank

Living Kidney Donors Network

Northeast Kidney Foundation

Polycystic Kidney Disease Foundation

Transplant Recipient International Organization

Transplant Support Organization



________________________Text of Letter__________________________



March X, 2019

Dear Secretary Azar and Administrator Sigounas,

We write to applaud your ongoing work to increase living organ donation in the United States, and we wish to share our commitment to working with you on this vital issue. At the end of 2016, there were 726,331 people living with end stage renal disease (ESRD)
and an estimated 30 million adults with some form of chronic kidney disease (CKD). Kidney transplantation is the most effective therapy for kidney failure, the ultimate outcome for many with CKD.

We were very pleased to see the Health Resources and Services Administration (HRSA’s) Healthcare Systems Bureau advance, “Lost Wages Support for Living Organ Donors Demonstration Project” (HRSA-19-069). We support further action to provide lost wages support,
such as expanding the scope of the National Living Donor Assistance Center (NLDAC). The fear of unemployment or taking unpaid time off from work is a common reason cited by those who choose not to donate and is a significant disincentive to organ donation. 

As you know, NLDAC provides approximately $1.9 million each year to reimburse travel expenses for eligible applicants. Last year, the program received over 1000 applications for assistance and nearly 9 out of 10 applications were approved. Importantly, 75%
of these donors indicated that they would not have been able to donate without the assistance provided by NLDAC. A recent peer-reviewed study found that for each $1 spent on the program it yielded $28 in Medicare savings in dialysis costs.

It is our understanding that The Organ Donation and Recovery Improvement Act (P.L. 108-216) would allow NLDAC to be expanded to cover lost wages and other non-travel expenses of donation. If the purview of the NLDAC were to be expanded,
for example, to cover lost wages, childcare, and other unreimbursed expenses incurred by a living donor, more individuals could donate and more transplants could occur saving valuable lives. We would like to work with you toward that end.


We thank you for your work to increase living donation and to address barriers that living donors face. We stand ready to work with you on strengthening the NLDAC, as well as other ways to remove disincentives so that more Americans will consider giving
the gift of life, through living organ donation. 





____________________________                                     ____________________________

            Matt Cartwright                                                                   Jaime Herrera Beutler

            Member of Congress                                                           Member of Congress


            ____________________________                                     ____________________________



            ____________________________                                     ____________________________

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