Transplantation with a living donor kidney is the best treatment for our patients with end-stage renal disease. That's why the UCSF transplant team is committed to removing as many obstacles as possible for those considering donation. Here's how the Advanced Donation Kidney Transplant Program can help.

Donating a kidney before it's required

Sometimes a patient needs a kidney transplant but isn't ready for immediate surgery. The patient may have a living donor who needs to move forward with donation surgery for personal or planning reasons. Or someone may be interested in donating a kidney to benefit an unknown patient in need, but worries that a friend or loved one might need a kidney in the future.

In these cases – when the need for a kidney transplant and a living donor's timeline for donating a kidney don't align – we can accommodate both through our program. Using a voucher system, individuals can donate a kidney at a time of their choosing instead of waiting until their chosen recipient is medically ready for the transplant.

How the voucher system works

There are two main categories of vouchers for advanced donations.

Standard vouchers: When a family member or friend is likely to need a kidney transplant within a year but the living donor prefers to donate sooner, a standard voucher is issued.

How standard vouchers work: The donor defines an ideal time for surgery and the patient is given a voucher to receive a kidney – when they're ready – from a different living donor through the National Kidney Registry. This option can be especially helpful in situations such as spouses who want to recover separately and help each other after surgery, or a teacher who needs to donate during a winter or summer break from school.

Family vouchers: These are for people willing to donate a kidney now for the possible future benefit of a loved one who has no immediate need for a kidney.

How family vouchers work: In this situation, the living donor issues vouchers for a future transplant to as many as five family members, who may or may not have a history of kidney disease. If a family voucher holder ever needs a transplant in the future, that person is prioritized to receive a living donor kidney through the National Kidney Registry. As soon as one person in the group uses a voucher, the other family vouchers are void.

This program can also benefit donors who know someone who may need a kidney transplant at a later time. For example, the potential donor may be the parent of a pediatric patient or a family member of a young transplant recipient who might need another transplant in the future. The program may also be appropriate for older donors who could become ineligible if they wait until their intended recipient needs a transplant.