On June 1, 2026, amendments to the German Transplantation Act (Transplantationsgesetz, TPG) entered into force. The reform eases restrictions on kidney transplants and is designed to increase crossover, or paired, living kidney donations. Legal Background The German Transplantation Act governs organ donations. Originally, the law allowed living kidney donations only if donations from deceased donors were unavailable. Also, only a narrow group of people with a special connection to the donor, such as first- or second-degree relatives, spouses, or fiancées, were allowed to donate living kidneys or any other living nonregenerative organs. (TPG, § 8, para. 1, sentence 2.) With these restrictions, lawmakers sought to ensure that donors were truly motivated by altruistic reasons, thereby preventing commercialization and the risk of organ trafficking, practices prohibited under section 17 of the Transplantation Act....