No, you cannot sell your kidney in the United States. The National Organ Transplant Act of 1984 makes buying, selling, or brokering a human kidney a federal crime punishable by up to five years in prison and a fine of up to $50,000. That prohibition applies in every state. What you can do is donate a kidney and be reimbursed for the costs the donation puts on you, including travel, lodging, and lost wages.
What Federal Law Prohibits
The controlling statute is 42 U.S.C. ยง 274e. It makes it illegal for anyone to knowingly acquire, receive, or otherwise transfer a human organ for “valuable consideration” for use in transplantation when the transaction affects interstate commerce.1Office of the Law Revision Counsel. 42 USC 274e – Prohibition of Organ Purchases The list of covered organs includes kidneys, livers, hearts, lungs, pancreases, bone marrow, corneas, eyes, bones, skin, and subparts of any of those.
“Valuable consideration” is the phrase that does the work. It covers money, but it also covers goods, services, or anything else of material value exchanged for the organ. A cash sale is illegal. So is a swap for a car, tuition, rent, or debt forgiveness. Congress drew this line to keep a market from pressuring low-income people to sell body parts and to prevent wealthier patients from buying their way past sicker ones on the waiting list.
The ban reaches everyone in the chain: the person selling, the person buying, and any broker or middleman who arranges the deal.
The Penalty for Selling a Kidney
A violation carries up to five years in federal prison, a fine of up to $50,000, or both.1Office of the Law Revision Counsel. 42 USC 274e – Prohibition of Organ Purchases
Prosecutions are rare but real. In 2011, Levy Izhak Rosenbaum pleaded guilty to brokering three illegal kidney transplants from donors in Israel to recipients in New Jersey. He was sentenced to two and a half years in federal prison and ordered to forfeit $420,000. Federal prosecutors described his case as the first conviction for black-market kidney sales under the National Organ Transplant Act.
What Donors Can Legally Receive
The statute allows a specific set of payments that don’t count as valuable consideration: reasonable costs of removing, transporting, processing, preserving, and storing the organ, plus the donor’s own travel expenses, housing, and lost wages tied to the donation.1Office of the Law Revision Counsel. 42 USC 274e – Prohibition of Organ Purchases The donor cannot profit from the kidney itself, but the donor also isn’t supposed to go broke because of the donation.
The Recipient’s Insurance Pays for the Surgery
The donor’s surgery and hospital stay are billed to the recipient’s insurance, not the donor’s. If the recipient has Medicare, Medicare pays the full cost of the donor’s care with no deductible and no coinsurance for either the donor or the recipient. The donor does not need to have Medicare themselves.2Medicare.gov. Medicare Coverage of Kidney Dialysis and Kidney Transplant Services Private insurance generally works the same way, though follow-up care and complications can leave gaps.
Reimbursement for Travel, Lodging, and Lost Wages
The National Living Donor Assistance Center, funded by the federal government, reimburses living donors for travel, lodging, meals, lost wages, and dependent care. Eligibility is based on the recipient’s household income, which must fall below 350% of the Federal Poverty Guidelines. For a household of four in the 48 contiguous states and D.C., that threshold is $115,500 in 2026.3National Living Donor Assistance Center. Who Can Apply Recipients above the income limit can apply for a financial hardship waiver.
Tax Deductions
Living donors can deduct unreimbursed medical and travel costs tied to the donation on their federal return. That includes medical care received as a donor, transportation to and from appointments, parking, and tolls.4Internal Revenue Service. Publication 502 – Medical and Dental Expenses For mileage, you can use actual gas and oil costs or the standard medical mileage rate, which is 20.5 cents per mile for 2026.5Internal Revenue Service. IRS Sets 2026 Business Standard Mileage Rate Only out-of-pocket costs that no program or insurer reimbursed can be deducted.
Several states offer their own tax credits or deductions for living organ donors, with amounts ranging from a few hundred dollars up to $25,000 depending on the state. Rules vary, so check your state tax agency.
Job-Protected Leave
The Department of Labor has said organ donation qualifies as a “serious health condition” under the Family and Medical Leave Act whenever it requires an overnight hospital stay, which kidney donation surgery does.6U.S. Department of Labor Wage and Hour Division. WHD Opinion Letter FMLA2018-2-A Eligible employees can take up to 12 weeks of unpaid, job-protected leave for the surgery and recovery. The FMLA covers employees who have worked at least 12 months for an employer with 50 or more employees, and the leave itself is unpaid.
Many states provide paid donor leave for state employees, ranging from about 5 days to 30 days or more, and some extend paid leave to private-sector workers. Check your state labor department before scheduling surgery.
Why Plasma, Blood, and Eggs Can Be Sold
Plasma centers and egg donation agencies pay donors because the statute lists specific organs it covers, and blood, plasma, sperm, and eggs are not on that list.1Office of the Law Revision Counsel. 42 USC 274e – Prohibition of Organ Purchases Congress treated materials the body replenishes differently from organs that are gone for good once removed.
Bone marrow is listed in the statute, but a 2012 Ninth Circuit decision in Flynn v. Holder held that when stem cells are collected through apheresis, a process similar to a blood draw where the body regenerates the cells within weeks, compensation is legal. That ruling applies in the states covered by the Ninth Circuit and has not been settled nationwide.
Is Selling a Kidney Legal in Any Country?
Iran is the only country with a legal, government-regulated kidney market. Patients and potential donors register with a nonprofit that arranges medical screening, compatibility testing, and a supervised payment negotiation. The Iranian government also provides donors with a year of health insurance and covers the transplant surgery at public hospitals.
The model is contested even among transplant professionals. Most sellers are low-income, and studies suggest many report regret and worse financial circumstances afterward. Iran has not eliminated its transplant waiting list either. No other country has adopted the approach, and international medical bodies broadly oppose legalizing organ sales. Traveling abroad to buy a kidney does not put a U.S. resident outside the reach of federal law when the transaction affects interstate commerce, which is how the Rosenbaum case reached prosecution in New Jersey.