04/23/2025
How the Voucher Program Works for Kidney Patients and Donors
February 19, 2025Jon Sullenberger, Vice President of Donor & Patient Advocacy
When you need a kidney transplant and are looking for a living kidney donor, the National Kidney Registry’s (NKR) Voucher Program can make the process more flexible and increase your chances of finding a match. This blog post will explain how the voucher process works, answer some common questions, and help you decide if it’s the right option for you and your potential donor.
What Is the Voucher Program?
The Voucher Program is a system that allows an eligible donor to donate their kidney in advance, securing a “voucher” for a specific recipient, known as the voucher holder. Instead of being transplanted directly into the voucher holder, the donor’s kidney goes to someone in need through the NKR’s paired donation network.
The voucher holder can redeem the voucher for a transplant using a kidney from a different living donor, with the NKR finding the best possible match. This approach provides flexibility, allowing donors to donate when it’s convenient and recipients to receive a kidney when it’s medically necessary.
How Does It Work?
Here’s a step-by-step breakdown of the process:
The Donor’s Decision: A willing donor registers with the NKR and is evaluated by their chosen transplant center. If they are deemed eligible to donate and are not a good match for their intended recipient, they can choose to participate in the Standard Voucher Program to get their intended recipient a better match.
The Donation and Swap: When the donor is ready to donate, they are activated in the NKR system and the NKR begins searching for a matching recipient. Once a well-matched recipient is identified, the donor proceeds with the donation and the kidney is transported to the recipient’s center and transplanted. Essentially, the donor is “swapping” their kidney for another kidney, which allows two different recipients to receive the best possible match.
The Voucher: Once the donor’s surgery is complete, their designated recipient receives a voucher. When the recipient is ready for a transplant, they can redeem the voucher and the NKR will begin searching its pool of donors for a good match. When a match is found, the matching donor proceeds with their donation and the kidney is transplanted into the voucher holder.
Why Choose the Voucher Program?
The Voucher Program offers several benefits:
Flexibility for Donors: Donors can have the donation surgery when it’s convenient for them, allowing them to plan around personal commitments.
Peace of Mind for Recipients: The Voucher Program ensures voucher holders will have access to a living donor kidney when they need it.
Increased Matching Opportunities: The paired donation system maximizes the chances of finding a compatible match for everyone involved.
Questions Potential Donors May Have
If you’re discussing the Voucher Program with a potential donor, they may have some important questions. Here are answers to a few common concerns:
1. What happens if I’m no longer eligible to donate? Donors can become unsuitable for donation at any point due to health changes or other factors. If a donor becomes ineligible, they can no longer serve as a voucher donor, and their intended recipient must find a new donor.
2. How is the surgery scheduled? Donors are asked to provide at least a three-week window of availability for the surgery. However, unforeseen events can sometimes delay or cancel the procedure.
3. What if the NKR ceases operations? In the extremely unlikely event that the NKR suspends operations, either temporarily or permanently, transplant centers will do their best to uphold the spirit of the Voucher Program by finding a match for the voucher holder.
4. Are voucher holders guaranteed to get a transplant? Unfortunately, no. While the Voucher Program significantly increases the likelihood of a successful transplant, it cannot guarantee that a voucher holder will receive a kidney. However, the vast majority of voucher recipients are matched and transplanted within 3-6 months.
5. Can the voucher be transferred to someone else? No. Vouchers are non-transferable and non-assignable—they can only be redeemed by the designated voucher holder.
6. Can I get more than one voucher? Under the Standard Voucher program, the donor’s donation generates a single voucher for the intended recipient. However, the donor can also name up to five loved ones as backup voucher holders. If the intended recipient ends up not using the voucher and one of the backup voucher holders ever needs a transplant in the future, they can redeem the voucher to be prioritized for a living donor kidney transplant. Once one voucher has been redeemed, all other vouchers are void.
If you have additional questions about the Voucher Program, please consult your transplant team.
