Living Kidney Donor: What is an Advanced (Voucher) Donation?

Have you considered donating your kidney, but want to save it for a loved one? 

Many people lead a healthy life with one kidney! Have you ever considered living kidney donation?

If you are considering giving away your kidney now, you might be concerned that a loved one will need your kidney in the future. Doing an advanced donation might be the solution you are looking for. Here are some situations to consider for an advanced kidney donation. 

  • You have children, family or friends that are healthy, but you are concerned they might need a kidney someday.
  • You know someone who has chronic kidney disease, but does not need a kidney now. 
  • You are a caregiver for someone who will need a kidney soon; you don’t want to have your donor surgery at the same time because you need to care for them as they recover from the transplant. 

There is something you can do to help: Advanced Kidney Donation. This is also described as a Voucher program.

Details of Advanced (Voucher) Kidney Donation. 

To use the Advanced (Voucher) program, you will donate your kidney to a stranger. This is called a non-directed donation. But donating this way can also help your loved ones! You donate now; in advance. And your loved one gets a kidney later when they need it (because of your donation).

The National Kidney Registry (NKR) currently has two types of advanced programs that transplant centers may offer. But not all centers provide this option, so you have to check on the center where you plan to donate. 

First is the Standard Voucher Program that can be used for anyone with kidney disease who is likely to need a transplant within one year. They can be someone you know or a stranger. You can donate your kidney when it is a good time for you. After you are approved to donate, you will be matched with someone who needs a kidney through the National Kidney Registry. Your kidney will go to a stranger as a non-directed donor. 

The person who needs the kidney will receive a voucher. This voucher is a piece of paper that both of you sign. You, the transplant center, and NKR keep copies of this voucher. Because you donated, the person listed can redeem their voucher when they are ready for a kidney transplant. At that time, they will be matched through the National Kidney Registry with a kidney donor.

Often better kidney matches can be found this way because there are so many people (donors and recipients) in the National Kidney Registry (a computer matching system). With more people, that means better matches can be found. That increases the chance of the kidney lasting longer.

Second is the Family Voucher Program.You are matched and donate to a stranger now (non-directed donation). You list up to 5 family members that can get vouchers for a kidney in the future. “Family” can be a spouse, child, parent, brother, sister, or a close friend that is like a family member. They don’t have to have kidney disease to be listed. Because you gave one kidney, know that only one person can get a kidney in the future.

Be sure to ask your donor transplant center about the advanced (voucher) option.

You might need to change to a center that offers this option. Information regarding kidney donation changes quickly. You can go to the National Kidney Registry website for advanced donation details and explore what is offered at transplant centers. See the links below under Resources

As you are thinking about kidney donation, consider your age, health, and social situation. If you wait for your loved one to “need” the kidney, you might not be able to donate later, due to changes.

Consider This!

If you want to donate a kidney before someone else needs the kidney, tell your transplant center that you want to donate as an Advanced Kidney Donor and use the Voucher Program

You can help your loved one in the future. You donate now and they get a kidney when they need it later.



Would you like more information about Living Kidney Donation, contact us at


Glenna Frey, APRN-CNS, is a nephrology nurse who donated her kidney in April 2017 to a stranger.
Amanda Frey, M.A., LMFT, LPC, is a Marriage & Family Therapist living with kidney disease.
Together, they co-founded Kidney Donor Conversations in 2018 to provide education about Living Kidney Donation.