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German Cabinet Approves Living-Kidney Reform Allowing Cross-Pair and Anonymous Donations

The proposal advances to parliament to cut years-long kidney waits through a national match system with tighter donor protections.

Overview

  • The federal cabinet adopted a draft law that would permit cross-pair living-kidney exchanges and non-directed anonymous donations.
  • A national program would create a pool of incompatible donor–recipient pairs and algorithmically match them for compatible exchanges.
  • Prospective donors would undergo mandatory independent psychosocial counseling and evaluation, with continuous support from transplant centers before and after surgery.
  • Donors who later require a transplant would receive priority access under the proposed rules.
  • Officials cite persistent scarcity: about 6,400 people were waiting for a kidney at the end of 2024, only 2,075 transplants occurred that year, more than 250 candidates died, and waits can stretch up to eight years.