Should You Start Looking for a Living Kidney Donor Before You Need a Kidney Transplant?
If you’ve been diagnosed with a type of chronic kidney disease (CKD), including polycystic kidney disease (PKD), diabetic kidney disease, or hypertensive nephropathy, you may feel like you’re always waiting—waiting for symptoms to get worse, for your kidney function to decline, for the day when you finally need a transplant. That day may still be years away. But waiting too long to start planning can make things much harder down the road.
You may not need a kidney transplant yet—but here’s why you should still think about finding a donor now.
One way to do this is through the National Kidney Registry’s Voucher Program, which allows someone to donate a kidney on your behalf now, even though you don’t need a transplant yet. Their kidney will go to a well-matched recipient who is in urgent need of a transplant. Their donation generates a voucher for you, which you can redeem for a living donor transplant when you need one—even if it is years later, because NKR vouchers never expire.
It’s like putting a kidney in the bank and saving it for a rainy day.
This is especially helpful for people with progressive kidney conditions, because it can be hard to know exactly when you’ll need a transplant. Having a voucher removes some of that uncertainty.
Why Not Wait?
Many people wait to look for a donor until they are close to needing a transplant. That makes sense logically, but it can lead to logistical delays. Testing potential donors takes time. If your first donor isn’t a match, you’ll need to test others. If someone changes their mind, you’re back to square one.
By starting the process early and finding a voucher donor now, you can avoid delays later. If you have a voucher, you can be activated in the NKR system immediately when you are cleared for a transplant.
If you already have a donor, the Voucher Program allows them to donate now when they are healthy and willing. There is no guarantee that a donor who is ready now will still be qualified at some future point when you are ready for a transplant. Donors who are healthy now might face age-related or health issues in the future that could disqualify them from donating. By donating now, they can avoid the risk of being ruled out later, ensuring that their gift will be ready when you need it.
But what if someone donates on your behalf and you never end up redeeming the voucher? In that case, your voucher donor’s kidney has already gone to someone who needed it, so the donation was not wasted.
Will My Center Allow It?
While the NKR recommends looking for a donor as soon as possible after diagnosis, it’s ultimately up to each transplant center whether they’ll accept a donor for someone who doesn’t yet need a transplant.
If this is something you’re considering, the best first step is to talk with your transplant team. Ask whether they’ll allow a donor to donate now to create a voucher for your future use. If the answer is no, you can always switch to an NKR Member Center that participates in the Voucher Program.
How to Explain This Approach to Potential Donors
The idea of asking someone to be your donor, especially when you don’t need a transplant yet, might feel uncomfortable. But you can reframe it this way: you’re not just asking someone to help you. You’re giving them a chance to save a life now and potentially your life later. That’s a powerful gift to offer.
If you have CKD, you might not need a kidney transplant right now. But there’s a good chance you will one day. Finding a donor early—before you need one—can make the process smoother, safer, and faster when the time comes. The earlier you begin, the more options you’ll have.
And remember: even if your donor gives a kidney you never need, someone else still gets a second chance at life. There’s no downside to being proactive.