Vouchers for Future Kidney Transplants to Overcome "Chronological Incompatibility" Between Living Donors and Recipients.
The waiting list for kidney transplantation is long. The creation of "vouchers" for future kidney transplants enables living donation to occur when optimal for the donor and transplantation to occur later, when and if needed by the recipient.



The donation of a kidney at a time that is optimal for the donor generates a "voucher" that only a specified recipient may redeem later when needed. The voucher provides the recipient with priority in being matched with a living donor from the end of a future transplantation chain. Besides its use in persons of advancing age with a limited window for donation, vouchers remove a disincentive to kidney donation, namely, a reluctance to donate now lest one's family member should need a transplant in the future.



We describe the first three voucher cases, in which advancing age might otherwise have deprived the donors the opportunity to provide a kidney to a family member. These 3 voucher donations functioned in a nondirected fashion and triggered 25 transplants through kidney paired donation across the United States.



The provision of a voucher to potential recipients whose need for a transplant makes them "chronologically incompatible" with their donors may increase the number of living donor transplants.
1 David Geffen School of Medicine at UCLA, Los Angeles, CA. 2 Gould School of Law, USC, Los Angeles, CA. 3 Keck School of Medicine, USC, Los Angeles, CA. 4 New York-Presbyterian Weill Cornell Medical Center, New York, CA. 5 Department of Economics, UCLA, Los Angeles, CA.
Jeffrey L
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Alexander M
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Gabriel
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Danovitch
H Albin
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Gritsch
Amy
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Waterman
Joseph
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Del Pizzo
Jim C
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Marek
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Pycia
Suzanne
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McGuire
Marian
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Charlton
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Kapur
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D033001:Directed Tissue Donation; D018450:Disease Progression; D046148:Donor Selection / Q000458:organization & administration; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D019520:Living Donors / Q000600:supply & distribution*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D061665:Time-to-Treatment; D066027:Transplant Recipients; D016896:Treatment Outcome; D014850:Waiting Lists