*Purpose: Despite regulations mandating follow-up laboratory testing for living kidney donors, less than half of transplant centers are in compliance. We sought to understand barriers to follow-up testing from the donors’ perspective.

*Methods: We surveyed our center’s previous living donors using a survey that was developed, piloted, and refined by transplant surgeons, transplant nephrologists, biostatisticians, qualitative research experts, research assistants, and a previous living kidney donor using a knowledge-based approach informed by existing literature. Binary logistic regression was used to assess factors associated with follow-up testing completion.

*Results: Of 185 living kidney donors, 110 (59.4%) participated. Among them, 82 (74.5%) completed 6-month laboratory testing, 76 (69.1%) completed 12-month testing, 68 (61.8%) completed both, and 21 (19.0%) completed neither.

Six-month testing completion was strongly associated with 12-month testing completion (OR 9.74, 95%CI: 2.23-42.50; P=0.002). Those who disagreed with the statements, “Getting labs checked wasn’t a priority for me,” (OR for completing 6-month testing: 15.05, 95%CI: 3.70-61.18; P<0.001; OR for completing 12-month testing: 5.85, 95%CI: 1.94-17.63; P=0.002); and, “I forgot to get labs drawn [until I was reminded]” (OR for completing 6-month testing: 6.93, 95%CI: 1.59-30.08; P=0.01; OR for completing 12-month testing: 6.55, 95%CI: 1.98-21.63; P=0.002) were more likely to complete testing.

*Conclusions: To our knowledge, this is the only study providing perspective on donor insights regarding the need for follow-up testing post donation. Interventions to influence living donor attitudes toward follow-up testing may improve follow-up.

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