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Kidney transplants are the second most common transplant operation in the United States (over 14,000 cases per year - cornea transplants are first). Compared to heart, lung, or liver transplants, it is an easier and less complicated operation.

The United Network for Organ Sharing (UNOS) is the private organization that runs the US transplant system under a contract with the federal government.

Despite continuing advances in medicine and technology, the demand for kidneys drastically outstrips the number of donors. In October 2002, there were 53,000 persons on waiting lists for kidney transplants in the US.

There are two types of kidney transplantation: cadaveric and living donor. Cadaver organs are distributed to those on a waiting list based on criteria set forth by UNOS. Live donor transplantation has become increasingly common, due in large part to the success of the procedure and the shortage of cadaveric organs. Living donation allows the immediate transplantation of kidneys into recipients so operations can be scheduled electively once a suitable living donor has been identified. This avoids the long waiting times encountered with cadaveric donation. A new procedure, the laparoscopic nephrectomy, has greatly reduced the trauma and recovery period for a living donor.

Kidney transplant recipients usually must take immunosuppressants, or anti-rejection drugs, for the rest of their lives. Medicare coverage for these medications is currently limited to three years, but federal legislation has been introduced to extend coverage. Immunosuppressant medications run on average between $1,000 - $1,200 monthly.