Non-directed living kidney donors

What is a Non-directed living kidney donor (NDD)?

An NDD is a person who chooses to donate a kidney without knowing the person who gets their kidney. NDDs are also sometimes called Good Samaritan or altruistic donors – they just want to help.

You may consider donating a kidney because you heard about a person who needs a transplant on the news, on social media, or in your community. If you donate to that person, the transplant center may still consider you an NDD because you don't have a relationship with the person who needs a kidney.

How can I be an NDD?

Step 1: You will need to go to a transplant center to complete thorough medical and other testing to see if you can donate a kidney. The transplant center will connect you to a donor team, which includes:

  • Doctors
  • Nurses
  • Social workers
  • Independent living donor advocate (someone who looks after your best interests during the donation process)

You may have other people on your team who help you through the donation process.

Step 2: If the transplant center finds that you’re healthy and emotionally able to donate, and you are well-informed and wish to proceed, you can decide how you would like to donate.

  • If you want to donate to someone you heard about online or in your community, the transplant center will find out if you’re a good match for that person
  • If you want to donate to anyone who needs a kidney, you can:
    • Donate to someone on the waitlist, which is the list of people who are waiting for a kidney transplant. Your kidney would go to the person highest on the list that is a good match for you.
    • Start a transplant chain. See the Kidney Paired Exchange chapter to learn more about transplant chains. Starting a transplant chain can take longer because the transplant center must set up the chain, but you may be able to help several people with your donation this way.

Will the person who gets my kidney find out who I am?

Non-directed donations start with an agreement of confidentiality and anonymity, which means the person who gets your kidney won’t find out who you are and you won’t know who they are, either. After the surgery has happened, you can exchange anonymous cards, and if both you and the recipient want to connect, the transplant center can help set up the meeting.

What else should I know about nondirected donation?

Research studies have shown that:

  • NDDs generally do very well in the donation process
  • Most NDDs say they get emotional and personal benefits from donating and have a similar quality of life before and after donating
  • The results of donations from NDDs are similar to donations from people who know the person who’s getting their kidney


1. Rodrigue, J. R., Pavlakis, M., Danovitch, G. M., Johnson, S. R., Karp, S. J., Khwaja, K., Hanto, D.W. and Mandelbrot, D. A. (2007), Evaluating Living Kidney Donors: Relationship Types, Psychosocial Criteria, and Consent Processes at US Transplant Programs. American Journal of Transplantation, 7: 2326–2332. doi: 10.1111/j.1600-6143.2007.01921

2. Henderson, A. J. Z., Landolt, M. A., McDonald, M. F., Barrable, W. M., Soos, J. G., Gourlay, W. Allison, C. J. and Landsberg, D. N. (2003), The Living Anonymous Kidney Donor: Lunatic or Saint?. American Journal of Transplantation, 3: 203–213. doi: 10.1034/j.1600-6143.2003.00019.

3. UNOS Policy 14: Living Donation. Found online  October 20, 2016.

4. Dew, M. A., Jacobs, C. L., Jowsey, S. G., et al. Guidelines for the Psychosocial Evaluation of Living Unrelated Kidney Donors in the United States. Am J of Transplant, 2007. 7: 1047–1054. doi: 10.1111/j.1600-6143.2007.01751

5. Rodrigue, JR, Schutzer, ME, Paek, M, Morrissey, P.. Altruistic Kidney Donation to a Stranger: Psychosocial and Functional Outcomes at Two US Transplant Centers. Transplantation. 2011 Apr 15;91(7):772-8. doi: 10.1097/TP.0b013e31820dd2bd.

6. Massey, EK, Kranenburg, LW, Zuidema, WC et al. Encouraging Psychological Outcomes After Altruistic Donation to a Stranger. Am J of Transplant, 2010 June, 10: 1445–1452. 

Note: This information is the opinion of the Living Donor Community of Practice (LDCOP) of the American Society of Transplantation. The LDCOP is a group of health care professionals and researchers who specialize in living kidney donation. The LDCOP’s recommendations are meant to offer you helpful information, but you may find opinions from other groups or organizations that are helpful to you, too.

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Last Updated: 
January 23, 2018