When Cindy Zbin learned she couldn’t donate part of her liver to her ailing husband, Dave, she was heartbroken. Luckily, he received a transplant from a deceased donor, saving his life. Just weeks after that, she made a bold decision — to donate 60% of her liver to a stranger.
“It’s the best thing I’ve ever done,” said Zbin, a 62-year-old retired nonprofit manager from San Jose. “I couldn’t help my husband, but I could help someone else.”
Zbin’s experience illustrates a growing trend in organ transplantation — living donation, where people give kidneys or portions of their liver while they’re still alive. It’s a procedure that saves more lives each year, but donations are not keeping pace with the need.
“There are always more people waiting than there are available organs,” said Danielle John, director of organ operations for Donor Network West, which connects donors to patients in California. “Our job is to maximize every single opportunity to save a life.”
Since 2014, more than 500,000 people in the U.S. have donated organs, 200,000 of them as living donors, according to a Bay Area News Group analysis of data from the Organ Procurement and Transplantation Network.
In 2024 alone, more than 24,000 people in the U.S. became donors. Living donations increased from about 5,800 in 2014 to more than 7,000 in 2024.
Since 2014, more than 120,000 Californians have become organ donors in California — 22,000 of them while living, including nearly 8,000 in the Bay Area.
Dr. Mark Melcher, chief of abdominal transplant surgery at Stanford Health Care, said he’s seen the Bay Area evolve into one of the country’s most competitive and capable transplant regions over nearly two decades, but also one where the wait can be grueling.
“Traditionally, the waiting list in the Bay Area has been significantly longer than in much of the country,” he said. “California has long wait times for both kidney and liver transplants.”
Zbin’s husband had liver disease and had been on the liver transplant waitlist for more than three years. After a series of surgeries, his liver began to fail. At one point, while sailing in Mexico in 2023, he collapsed from a serious infection and had to be airlifted to UC San Francisco Medical Center.
“We thought he wouldn’t make it,” Zbin recalled. “They told us he had to be transplanted by December. December came and went, but still no liver.”
Then, in February 2024, they got the call. A liver from a 27-year-old donor who had died had become available.
“It saved his life,” she said. “We’ve been married 42 years. We have three kids and seven grandkids. We got our life back.”
Three weeks later, Zbin made her own decision. She donated 60% of her liver to an anonymous recipient.
“I had been through it,” Zbin said. “I had sat in that hospital. I had watched other families. I just knew I had to do it. There was no pressure. It was personal. Physically, my liver has grown back. I feel great. But emotionally, I feel different, better. It changed me. It’s the greatest feeling to know I helped someone live.”
John, the organ donor facilitator, who spent years helping build the living donor program at California Pacific Medical Center, said stories like Zbin’s are becoming more common, but still not common enough.
“Living donors are some of the most selfless people I’ve ever met,” she said. “Whether they know the recipient or not, they’re stepping forward to give life.”
Programs like paired exchanges and donation chains allow incompatible donors to help each other across a network.
“Say you want to donate to me, but we’re not a match,” John said. “We can still help each other through a swap. Or if you’re an altruistic donor, you can kick off a chain that saves multiple lives.”
Many people don’t know they can be living donors. Others are swayed by myths or fear. John said education and community engagement are critical, especially in a diverse region like the Bay Area.
“It’s important for people to see others who look like them receiving transplants,” John said. “It makes it real. It gives them hope.”
Kristin Holtzman, who coordinates operating room setup, patient safety and team support at Donor Network West in Oakdale, California, committed to becoming a living donor herself.
“When I started at Donor Network West, I learned about the path of living organ donation,” she said. “A few years later, my cousin donated a kidney to my uncle — that was my first personal connection to a living donor. Watching the change it made for my uncle planted the seed for me.”
She went through the National Kidney Registry and chose UCSF for her donation due to its large living donor program and waitlist. After six months of evaluations, she was approved and scheduled for surgery as a non-directed donor.
“I later found out my left kidney now lives in Hawaii,” Holtzman said. “It lucked out.”
Holtzman could list five people who could be prioritized for her kidney through the registry’s voucher program.
“It’s a way to help someone now while also protecting someone close to you in the future,” she said.
Her recovery was smooth. “I was in the hospital for two days,” she said. “I was uncomfortable for about three days, but it was manageable with medication. I started running again three weeks after surgery.”
“I honestly feel like I was meant to have one kidney,” she said. “Everything returned to normal so quickly. I’ve benefited as much as I hope my recipient has. It’s enriched my life in ways I couldn’t have imagined.”
The highest numbers on the waiting list are for kidneys, mostly due to damage from diabetes and high blood pressure, and livers, often tied to fatty liver disease or alcohol use, Melcher said. Liver patients face a more urgent need.
“The difference with liver is that there’s no dialysis alternative,” he said. “People can die waiting.”
Nearly 20,000 Californians are waiting for organ transplants, most of them, over 17,800, need a kidney, according to the transplant network’s data. Others wait for livers, hearts, lungs or multiple organ transplants. More than 4,100 have been on the list for five years or longer. In the Bay Area, more than 7,600 people are waiting for organ transplants.
Zbin, now back to snowboarding, boating and traveling with her husband, hopes others will consider live organ donation.
“If you’re thinking about it, at least get tested,” she said. “You don’t have to be young or athletic. I’m a small older woman.”
She also urges people to register as deceased donors.
“That one conversation can save lives,” she said. “It saved my husband’s.”