Ensuring the need is met: A 50-year simulation study of the National Kidney Registry’s family voucher program

Matthew Cooper, David B. Leeser, Stuart M. Flechner, Jennifer L. Beaumont, Amy D. Waterman, Patrick W. Shannon, Matthew Ronin, Garet Hil, Jeffrey L. Veale

    Research output: Contribution to journalArticlepeer-review

    10 Scopus citations


    The National Kidney Registry (NKR) Advanced Donation Program enables living donors the opportunity to donate altruistically, or in advance of a potential recipient's transplant, and to receive a voucher that can be redeemed for a future transplant facilitated by the NKR. Family vouchers allow a donor to identify multiple individuals within their immediate family, with the first person in that group in need of a transplant being prioritized to receive a kidney. An increase in vouchers introduces concerns that demand for future voucher redemptions could exceed the supply of available donors and kidneys. A Monte Carlo simulation model was constructed to estimate the annual number of voucher redemptions relative to the number of kidneys available over a 50-year time horizon under several projected scenarios for growth of the program. In all simulated scenarios, the number of available kidneys exceeded voucher redemptions every year. While not able to account for all real-life scenarios, this simulation study found that the NKR should be able to satisfy the likely redemption of increasing numbers of vouchers under a range of possible scenarios over a 50-year time horizon. This modeling exercise suggests that a donor family's future needs can be satisfied through the voucher program.

    Original languageEnglish (US)
    Pages (from-to)1128-1137
    Number of pages10
    JournalAmerican Journal of Transplantation
    Issue number3
    StatePublished - Mar 2021


    • donors and donation: living
    • donors and donation: paired exchange
    • ethics
    • ethics and public policy
    • kidney transplantation/nephrology
    • kidney transplantation: living donor
    • simulation
    • Humans
    • Tissue and Organ Procurement
    • Kidney Transplantation
    • Living Donors
    • Kidney
    • Registries

    ASJC Scopus subject areas

    • Transplantation
    • Pharmacology (medical)
    • Immunology and Allergy


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