*Purpose: To better understand racial/ethnic disparities associated with kidney living donation, this study examined differences in potential living kidney donors’ decision-making, resistance to donation, and differences by relationship to recipient at the start of evaluation.

*Methods: 2576 potential donors from five transplant centers, with no clear medical contraindications, were surveyed.

*Results: Potential donors were 16% Black, 21% Hispanic, 9% Asian, 60% female, and mean of 44 years old (SD, 13), 23% with a high school education or less. Most planned to donate to a friend/acquaintance (20%), parent (19%), spouse/partner (19%), or sibling (16%), though White donors were most likely to be donating to a friend, Black donors to a parent, and Asian donors to their spouse (Figure). The decision to donate was instantaneous for the majority (64%) with more potential donors deciding instantaneously if the recipient was their child (80%), spouse (75%), sibling (69%) or parent (70%). Compared to Whites (62%), Black potential donors were significantly more likely (70%) and Asians were less likely to decide instantaneously (55%) (P = 0.001). When exploring resistance to becoming a donor, 10% of potential donors agreed with the statement “I sometimes wish the recipient would get a transplant from someone else instead of me,” with Asians reporting greater concern (16% vs. 5-10%; P < 0.001). A minority of Asian (17%), Hispanic (14%), White (12%) and Black donors (8%) had someone important in their life who did not want them to donate (p=0.008).

*Conclusions: Clinical sensitivity is necessary for potential donors of different races/ethnicities, due to differences in their decision-making, family support for donation, and willingness to donate to different potential recipients.

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