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Voucher Program

Kidney donation is major surgery involving:
  • Medical tests which will require at least one full day at the hospital.
  • 1-3 days in the hospital after surgery.
  • Typically 2 - 4 weeks off work for recovery

For a review of kidney donation risks, click here.

The NKR Voucher program allows donors to donate their kidney many years before their intended recipient may need a kidney. Some Voucher donors have donated 20+ years before their intended recipient is expected to need a transplant with the hope that their intended recipient will never need a transplant. The Voucher program is a subset of the NKR Advanced Donation Program which began in 2011.

  1. Voucher donor is 64 years old and will be too old to donate to a grandchild who has been diagnosed with a kidney problem which may require a kidney transplant in 15 years.
  2. Recipient has a current functioning allograft but may need a second transplant in 20 years. The father is 52 and wants to donate but will be too old in 20 years.
  3. The Voucher Recipient has not been diagnosed with any kidney disease, but there is a known genetic propensity that has increased risk. The father wants to donate both to help other people now as a Good Samaritan Donor, but he also wants to make sure there is a voucher for his daughter if she does happen to develop kidney disease.
  1. There is no guarantee that the patient can be matched and transplanted.
  2. The Voucher donor and recipient must complete and return the Informed Consent documents to apply for participation in the program.
  3. An ADP donor may identify one intended recipient.
  4. An ADP Recipient may have up to five ADP Donors
  5. The Voucher donor and intended recipient can be at different centers but both centers must be participating in the program.
  6. The intended Voucher recipient must be a kidney transplant recipient or currently have, or be expected to have, some form of renal function impairment.
  7. The Voucher expires when the intended recipient expires and it cannot be transferred.
  8. The donor cannot withdraw the Voucher from the intended recipient after kidney donation.
  9. The intended recipient may only redeem the Voucher when transplantation is indicated as a therapeutic modality for End Stage Kidney Disease.
  10. If the NKR were to undergo a change of control, the surviving organization must honor all Vouchers with the same or better capacity to fulfill all outstanding Voucher obligations.
  11. The intended recipient is required to provide government photo identification and a blood sample so that the HLA and blood type can be confirmed before a Voucher’ can be redeemed.

We've got your back

Two senior leaders in the NKR organization, including the CEO, are living kidney donors who donated their kidneys and started chains. As such, we intimately understand the living donor process and are committed to ensuring a convenient and safe donation experience for all living kidney donors.

The NKR provides 'kidney prioritization' to all NKR swap donors enabled by our Medical Board policy that states that, should an NKR donor's remaining kidney ever fail, they will be prioritized in the NKR program to receive a living donor kidney. This is in addition to the prioritization points that a living donor receives on the national deceased donor wait list. Research shows that living donor kidney transplants last approximately twice as long as deceased donor kidneys. The NKR prioritization for a living donor kidney provides additional reassurance in the unlikely case that a donor will ever need a kidney transplant.

In the unlikely event that a kidney donor experiences post-surgical complications (e.g. hernia, etc.) related to kidney donation, the medical costs should be paid for by the recipient's medical insurance. Sometimes insurance companies avoid paying these costs by limiting the time period that they will pay for donor complications, and sometimes they ask the donor for a co-payment for donor complications. While these instances are very rare, they do happen. Through the NKR's Donor Protection Program, we ensure that any donor who participates in an NKR swap is never asked to pay for a post-surgical complication that is a result of their kidney donation. Member Centers that opt into NKR’s Donor Protection Program agree to either cover all uncovered donor complications for NKR donors that undergo donor surgery at the Member Center's Hospital, or the Member Center is charged a fee that is added to the NKR Donor Protection Fund that is used to pay for NKR donor complications. If you have an uncovered complication related to your kidney donation in an NKR swap, please speak to the transplant program that performed your surgery so that we can ensure that you are not asked to pay for any costs related to the complication.

Generally most employers and insurance companies are supportive of living kidney donation. Some employers (e.g. the Federal Government, the National Kidney Registry, etc.) offer paid leave to employees that donate a kidney. However, we have seen situations where employers are not so supportive. In one situation, the NKR was instrumental in winning a wrongful termination case when a donor involved in an NKR living swap was fired for taking time off work to donate. We also understand that some donors, after they donate, lose their health insurance or see health insurance premium increases due to donating a kidney. These cases are very rare, but are wrong. If you donate your kidney as a part of an NKR swap and are wrongfully terminated, see a rise in insurance premiums, or lose your health insurance as a result of your donation, the NKR will stand behind you and our legal counsel will advocate on your behalf.

Have you ever noticed that organizations who routinely survey customer satisfaction generally provide better service? If you are referred to a transplant center from the NKR web site you will be given an opportunity to provide direct feedback to the center via the “Five Star Survey”. The survey is sent to the donor via email upon completion of the following key steps in the donation process: workup, pre-op testing, surgery + 3 days & surgery +30 days. The satisfaction survey is designed to take less than 5 minutes to complete and allows Members Centers to continuously improve the donation process.

Paper-based donor screening and medical history data collection is inconvenient for donors. To make matters worse, many donor candidates are asked to fill out medical history forms multiple times during the intake process. The NKR has eliminated this problem by collecting screening and medical history data in an easy to use web based format. Once the candidate completes the screening and medical history, the data is electronically transferred to the transplant center.

Tests to determine compatibility between donor and recipient can require the donor to complete frequent blood draws to support multiple cross match tests with potential swap recipients. To avoid these multiple cross match blood draws, the NKR provides donor blood cryopreservation services which allow for the freezing and storage of the donor blood that can be used for up to seven cross match tests, reducing the number of times the donor is required to complete blood draws.

Other reasons to choose NKR

The Advanced Donation Program (ADP) is a kidney paired exchange separated in time. There are two types of ADP cases 1) Standard Voucher, where the intended recipient is on dialysis or is in imminent need of a kidney transplant and 2) Family Voucher, where the intended recipients are currently not in need of a kidney transplant and may never need a transplant. Both types of ADP cases allow donors to donate their kidney before their intended recipient receives a kidney. Some ADP donors have donated just a few months before their intended recipient was transplanted (short term cases). Some ADP donors have donated 20+ years before their intended recipient is expected to need a transplant (voucher cases) with the hope that their intended recipient will never need a transplant.

Donors donating through either the Advanced Donation Program or donating as Good Samaritan donors can specify the date range that they are able to donate. We generally need a minimum of four weeks from donor activation to swap commencement to organize a swap.

The typical kidney transplant chain facilitates four transplants, and each donor in that chain is an integral link to helping each patient get a compatible kidney. Each donor is a unique match for patients in the system, and by being a part of our chains makes not just one, but potentially many transplants possible.

The NKR has the largest pool of donors in the world. Our large pool is the key to finding a better donor-recipient match and is particularly helpful for highly sensitized patients. Highly sensitized patients are patients whose body has a strong immune response to the majority of donors, so the larger the pool the more chance of finding a matching kidney.

The NKR has the largest pool of donors in the world, providing patients the best chance of finding a well matched living donor kidney. A good donor-recipient match is correlated with a transplant that last longer. Patient outcomes from transplants facilitated by the NKR exceed the average U.S. living donor transplant outcomes at 1, 3 and 5 years. We believe this is driven by the improved donor - recipient matches available through the NKR.

With a median wait time of ~2 months, we get the majority of our patients transplanted fast.

To get started

  1. Complete the NKR Screening. 5 mins
  2. If cleared, next day, complete full medical history. ~1 hour
  3. Center will contact you. ~3 days

Then, (may vary slightly by center)

  • Complete workups & labs. 1-2 days
  • Get cleared for donation. 1-4 weeks
  • NKR organizes swap.
  • Schedule Pre-Op and Surgery
  • Complete Pre-Op
  • Complete Surgery

After Surgery

  • Periodic follow-ups

When you're ready to get started with the screening process, click the button below.

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