At last count, 409 people in Hawaii were waiting for a kidney transplant, but an average of only 45 such procedures were performed here annually over the last 10 years because there aren’t nearly enough organ donors, according to data from United Network for Organ Sharing, which manages the nation’s organ procurement and transplantation network.

“With the highest per capita rate of kidney and liver disease in the United States, there is a tremendous need in Hawaii for living and deceased donors,” said Dr. Alan Cheung of the Transplant Center at Queen’s Medical Center.

Of the 51 kidney transplants in Hawaii last year, only eight involved living donors.

Kidneys from living donors make for the most successful of transplant procedures, according to the Living Kidney Donors Network. Most result from “directed donations” in which the donor specifies the recipient. Nondirected or altruistic living donations involve donors who volunteer to give up one of their kidneys to anyone who needs a transplant.

Cheung, who has performed more than 600 kidney transplants, said that happens only once or twice a year in Hawaii.

“It takes a very kind, altruistic, special type of person to want to donate to another person,” he said.

Diana Benningfield, senior director of the National Kidney Foundation of Hawaii, said the islands lag behind other states in living organ donations due to cultural issues, lack of awareness and other reasons. One misconception is that it’s hard to match unrelated donors and recipients when it comes to blood type and other factors. Because of new, more effective anti-rejection drugs, that’s no longer the case.

“If someone wants to donate a kidney and they’re really healthy, there’s a nearly 100 percent chance they’ll find a recipient,” Benningfield said.

Some other things to know: Studies have shown that a living kidney donation does not reduce the donor’s life expectancy; medical costs are covered by the recipient’s insurance; and while it’s rare for a donor to need a kidney transplant of their own later in life, if that does happen, they will get priority status on the waiting list, she said.

Benningfield was inspired by her work at the Kidney Foundation to become an altruistic donor. In 2008 one of her kidneys was transplanted into a 4-year-old Hawaii boy.

“Being a living donor is a real opportunity to save someone’s life,” she said. “It is a gift.”