*Purpose: Anonymous Living Donors are a special select set of donors. As there continues to be advances in Paired Donation, we review the trends and the characteristics and utilization of such donors nationally.

*Methods: All Living Donors who were recorded in the UNOS database as Code 10 (Anonymous) who donated from Oct 1997 through Sep 2017 were reviewed for demographics as well the Recipients Demographics and Outcomes who received such Kidney Transplants. We also reviewed significant characteristics such as extreme Age or BMI mismatching.

*Results: Results: There were a total of 2,286 such donors during the study period.

DCGS was significantly superior when Donor was 20 or more years younger than Recipient (p=0.019). DCGS was significantly inferior when Donor was 20 years of more older than recipient (p=0.0005). There was no significant difference in unadjusted GS between Adult and Pediatric Recipients p=0.559. But Adult DCGS was significantly higher than pediatric (p=0.021).

*Conclusions: Transplants from Anonymous Living Donors show a wide variation in Recipient Characteristics. Aside from expanding the donor pool, as Kidney Paired Donation becomes an increasingly common approach, better characteristics matching of such altruistic donors may provide superior outcomes.

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