A 100-year simulation of the National Kidney Registry's voucher program

Area of Science:

• Nephrology
• Transplantation Medicine
• Public Health

Background:

• Living kidney donation is crucial for addressing end-stage renal disease.
• The National Kidney Registry (NKR) developed voucher programs to enhance donation rates.
• Two types of vouchers exist: standard and family vouchers (FVs).

Purpose of the Study:

• To evaluate the long-term viability of the NKR voucher program.
• To project the capacity of the voucher program to meet future redemption demands.
• To assess the sustainability of both standard and family voucher systems over 100 years.

Main Methods:

• A 100-year Monte Carlo simulation model was employed.
• Demographic data from existing and past donors and voucher holders were utilized.
• Four distinct program activity scenarios were simulated.

Main Results:

• All simulated scenarios indicated sufficient kidney availability for predicted voucher redemptions.
• The 'Most Likely' scenario projects 390,000 new donors versus 300,000 redemptions.
• Over 100 years, 94,000 new FV donors are projected against 3,700 FV redemptions.

Conclusions:

• The NKR voucher program is projected to be sustainable over a 100-year horizon.
• The simulation demonstrates the program's capacity to meet likely voucher redemptions under various scenarios.
• The voucher program is a viable strategy for increasing living kidney donation.