*Purpose: The risk-benefit framework currently used in living organ donation presumes all benefit is afforded to the recipient, whereas the donor only assumes risks. However, additional measurable benefits may be granted to the donor that are neglected in current paradigms of risk-benefit analyses.

*Methods: We conducted in-depth interviews with 56 living kidney donors regarding their decision to donate and any benefits they experienced from donation (Table 1). Interviews were conducted and recorded over a 5 week period. Using grounded theory, qualitative themes were derived from interview transcripts by two independent coders; differences in coding were reconciled until reaching consensus. These themes were then analyzed for common patterns.

*Results: Twenty-five participants were in interdependent relationships with their recipients (i.e. partner or parent to child) meaning they had a shared household and/or significant caregiving responsibilities. Participants reported they were motivated to donate a kidney based on a more nuanced understanding of the benefits of donation than accounted for by the current paradigm. Some additional benefits included improvements in caregiving burden, wage earnings, donor independence, and the donor’s ability to have children with the recipient (Table 2).

*Conclusions: Participants’ evaluation of the benefits of organ donation included tangible benefits currently overlooked in live donor transplantation decisions. These additional benefits may alter present risk-benefit calculations so as to allow a greater threshold of acceptable donor risk. This in turn may expand the pool of potential donors which has significant implications for transplant medicine.

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