The National Kidney Registry (NKR) Voucher Program allows a living kidney donor to choose the most convenient time frame for their kidney donation surgery and provide one or more vouchers to people who can then be prioritized to receive a living donor kidney through the NKR if/when they need a transplant.
Voucher donation is generally referred to as a paired exchange separated in time and allows donors to overcome chronological incompatibility.
The standard voucher is utilized when a family member or friend is expected to need a kidney transplant within a year and the donor would like to donate sooner rather than later. That person can receive a voucher for a future transplant.
The standard voucher is generally utilized when the donor is ready to donate, but has a time frame limitation and the patient cannot be transplanted during that limited time frame.
Remote donation, which allows donors to avoid traveling to a distant transplant center to undergo their donor surgery, is available to all standard voucher donors. Learn more about the Standard Voucher Program.
The family voucher is utilized when a donor does not have someone in immediate need of a kidney transplant (expects to need a transplant within one year), but wants to help others in need of a transplant by donating their kidney while still looking out for their family’s potential future kidney transplant needs.
The family voucher allows for up to five family members to receive vouchers. Family members may include spouses, biological or legal offspring, parents and siblings. Once the first voucher holder is activated to receive a kidney, all other vouchers related to that donor become void and cannot be redeemed.
All voucher holders are required to complete a cheek swab DNA test (for future identification purposes) and a kidney function screening test after the voucher donor donates, as well as every five years while the voucher is active. Learn more about the Family Voucher Program.
The swap saver is used when there is a problem with a swap (e.g., the paired recipient becomes sick, etc.) and the paired donor decides to proceed with the scheduled surgery to keep the rest of the swap on schedule. The paired recipient is prioritized for a transplant in a future swap when they are healthy enough to undergo transplant surgery.
Real-Time Swap Failure
A real-time swap failure occurs when there is a problem with a swap and the paired donor donates but the paired recipient does not get a kidney transplant. In these cases, the patient is prioritized for a transplant in a future swap. Real-time swap failures are rare and happen in approximately 1 in 300 cases. Historically, all patients involved in real-time swap failures have eventually been matched and transplanted through the National Kidney Registry (NKR).