Kidney donations rise in Netherlands, but hundreds still die waiting
Rising numbers of kidney donors in the Netherlands are failing to meet the growing demand for transplants, leaving around 200 patients each year without a new kidney in time, according to figures released by the Nierstichting (Kidney Foundation).
The shortfall comes despite a significant increase in donations following the 2020 revision of the Wet op orgaandonatie (Organ Donation Act), which made everyone a donor by default. Since the law changed, the number of kidney transplants has risen from 442 in 2020 to 639 in 2024. Still, the need reportedly continues to outpace availability.
“The number of donors may have increased,” Tom Oostrom, director of the Nierstichting (Kidney Foundation), told NOS, “but so has the number of people who need a new kidney.”
To address the gap, the Nierstichting is launching a national awareness campaign. The initiative comes amid a so-called "double aging" trend — not only is the population getting older, but people are also living longer, which increases the number of individuals suffering from kidney failure.
“What could truly make a difference is if more people were willing to donate a kidney while they are still alive, not only after death,” Oostrom told NOS.
Each year, about 500 people donate a kidney while living, usually to a family member. A healthy person can live a full life with one kidney, but the decision remains deeply personal and often emotionally complex.
“The question to donate isn't always experienced as optional,” Marion Siebelink, head of the transplant center at UMC Groningen and chair of the medical ethics committee of the Dutch Transplant Association, told NOS. “In theory, it’s easy to say no, but in practice it’s often much harder and can lead to feelings of guilt. What if you're too scared to give a kidney to a family member, or would rather keep it in case your child ever needs one? It can completely shift the dynamics within a family.”
Marianne Hoekstra faced that dilemma when her sister initially offered to donate but was later ruled out for medical reasons. With her health rapidly deteriorating, Hoekstra turned to her social network for help.
“Some people responded positively, but others were incredibly angry,” she told NOS. “They felt I was asking too much. I can understand why people might feel that way.”
Eventually, a distant acquaintance, Jeroen Ester, proved to be a suitable match. In March, Hoekstra received a healthy kidney. “You give someone a new life, but you also receive something in return,” Ester told NOS. “It truly is a gift to see what your kidney can do for someone else.”
The Nierstichting wants to dispel misconceptions about live kidney donation, including the false belief that donations must be to family members. Donors can also give anonymously through academic hospitals, provided their kidney is deemed suitable after a thorough medical screening.
“A kidney from a living donor typically lasts more than 20 years — about twice as long as one from a deceased donor,” Oostrom told NOS. “And the health risks are minimal. You can only donate after undergoing an extensive examination. Once approved, most people can return to normal activities relatively quickly after surgery.”
Oostrom called for a broader societal conversation about living donation: “The growing demand for care and kidney donors forces us to confront this issue. We need to talk about live donation, one way or another.”
Siebelink agreed. “That conversation is crucial. The double aging process has begun, and it demands difficult ethical questions. How can we responsibly ask society to consider donating while alive? And as hard as it is, do we need to accept that we may not be able to save every life? But who gets to decide that? Age? Lifestyle? There won’t be easy answers.”
Still, Oostrom clarified that the Nierstichting is not calling on the entire population to donate a kidney. “That would be going too far,” he told NOS. “But we do want people to understand this issue is real. Because sooner or later, we all will have to face it.”
