Project Donor: A National Intervention to Improve the Health of Potential Living Donors

The number of living donors in the US has stagnated for over two decades, in part because a substantial number of intended donors are disqualified due to potentially modifiable health conditions like obesity and smoking. Although these conditions can be improved with lifestyle changes, many candidates lack the support to achieve these changes on their own.

Project Donor is a national program to help living donor candidates achieve donation eligibility. Project Donor provides individualized virtual case management and free access to commercially available programs, including Noom, Weight Watchers, and OnPoint Nutrition, as well as nicotine replacement products and talk therapy.

Between May 2022 and January 2025, Project Donor enrolled 680 participants. Among these, 142 continue working toward their goals, 435 dropped out, and 95 reached their goal after achieving a mean 8.1 kg weight loss over 9.5 months. Participants who reached their weight loss goal had a lower starting weight (93.4 vs. 101.7 kg, p < 0.001) and BMI (34.1 vs. 36.7 kg/m², p < 0.001) than those who dropped out. Among those who reached their goal, 72 went on to become living donors.

These results indicate that with sufficient resources and support, some potential donors can achieve eligibility for donation through lifestyle interventions. While a high dropout rate and lack of a control group limit the generalizability of this study, we demonstrate how lifestyle interventions for living donors can be implemented at scale. Additional studies are warranted to determine whether programs like Project Donor could increase the number of living donations.