Why does Madeleine betray Ethan?

She is forced to by her undercover orders.

Who receives public credit for the kidney donation?

Emma falsely claims to be the donor.

Her Secret, His Regret

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Her Secret, His Regret — An undercover operative sacrifices her kidney for the lover she was ordered to betray, then disappears while an impostor takes the glory.

Agent Madeleine receives orders that compel her to turn on Ethan, leaving him fighting for survival. She arranges a secret kidney transplant to keep him alive, yet allows Emma to accept public recognition as the donor. Five years pass before their paths cross again. Ethan has since built a business empire and hardened his heart, now pledged to marry Emma. Madeleine returns to hazardous covert work while Hayes, a powerful figure with personal feelings for her, offers protection and influence in exchange for her loyalty. Caught between the man she saved in silence and the one who promises safety, she navigates escalating danger as buried truths threaten to surface.

Quick answers

Why does Madeleine betray Ethan?: She is forced to by her undercover orders.
Who receives public credit for the kidney donation?: Emma falsely claims to be the donor.